Insulin ndiye mahomoni akuluakulu omwe amachepetsa kuchuluka kwa shuga ndipo amachititsa kuti shuga azipanga gawo lililonse mthupi. Komanso ntchito za mahomoni ndikupangitsa kuphatikiza mapuloteni, mafuta komanso kuthamangitsa kayendedwe ka amino acid, potaziyamu, magnesium, phosphorous ndi zina zamagazi.
Ngati kapamba, yemwe amayenera kutulutsa insulini, wasokonezeka, ndiye kuti thupi limaleka kulandira mphamvu kuchokera ku chakudya. Zotsatira zake, kuchuluka kwa insulin kumachepa, ndipo kuchuluka kwa glucose m'magazi, m'malo mwake, kumawonjezeka. Komabe, kuchuluka kwa shuga kotere sikumagwiritsidwa ntchito pa cholinga chake, chifukwa chomwe thupi limakhala ndi njala yamphamvu ndipo maselo ake amayamba kufa.
Umu ndi momwe matenda a shuga amakulira. M'mbuyomu, anthu omwe ali ndi matenda otere adalandidwa, koma lero, chifukwa cha chitukuko cha asayansi ndi madotolo, adapeza mwayi wokhala ndi moyo mothandizidwa ndi insulin yokumba.
Kukonzekera kwa insulin ndi borus komanso basal. Zoyambazo zimagwiritsidwa ntchito kulipirira mkhalidwe mutatha kudya, ndipo chomalizacho chimapangidwa kuti azithandizira thupi. Chimodzi mwa mankhwala abwino kwambiri m'gululi ndi Bazal insulin.
Insulin Bazal: mikhalidwe yayikulu
Awa ndi mankhwala a hypoglycemic omwe amagwiritsidwa ntchito ngati mtundu wa matenda a shuga a insulin. Gawo lomwe limagwiritsa ntchito mankhwalawa ndi insulin yaumunthu.
Mankhwalawa ndi kuyimitsidwa koyera kwa subcutaneous makonzedwe. Ndi gawo la gulu la insulin ndi mawonekedwe awo, omwe ali ndi zotsatira zapakati.
Insulin Insuman Bazal GT imagwira ntchito pang'onopang'ono, koma zotsatira zake pambuyo pakukonzekera zimatenga nthawi yayitali. Kupendekera kwakukulu kwambiri kumachitika patatha maola 3-4 kuchokera pakubayidwa ndipo kumatha mpaka maola 20.
Mfundo ya mankhwalawa ndi motere:
- Imachepetsa glycogenolysis ndi glyconeogeneis;
- amachepetsa kuchuluka kwa shuga m'magazi, amachepetsa mphamvu ya catabolic, ndikuthandizira pakubwera kwa anabolic;
- linalake ndipo tikulephera lipolysis;
- imapangitsa mapangidwe a glycogen mu minofu, chiwindi ndi kusamutsa glucose pakati pa maselo;
- amalimbikitsa kuchuluka kwa potaziyamu kumaselo;
- imayendetsa kaphatikizidwe ka mapuloteni komanso njira yoperekera amino acid ku maselo;
- bwino mauxia mu chiwindi ndi adipose minofu;
- amalimbikitsa kugwiritsidwa ntchito kwa pyruvate.
Mwa anthu athanzi, theka la moyo wa mankhwala kuchokera m'magazi amatenga mphindi 4 mpaka 6. Koma ndi matenda a impso, nthawi imachuluka, koma izi sizikhudza kagayidwe kachakudya ka mankhwala.
Malangizo ogwiritsira ntchito mankhwalawa
Dokotala wokhazikika yemwe ayenera kusankha kuchuluka kwa kukonzekera kwa insulin kutengera moyo wa wodwala, ntchito ndi zakudya. Komanso kuchuluka kwake kumawerengeredwa pamaziko a zisonyezo za glycemia komanso mkhalidwe wa metabolism ya carbohydrate.
Wapakati tsiku lililonse mlingo kuyambira 0,5 kuti 1.0 IU / pa 1 makilogalamu kulemera. Pankhaniyi, 40-60% ya mlingo amaperekedwa chifukwa cha insulin yayitali.
Ndizofunikira kudziwa kuti mukasintha kuchokera ku insulin ya nyama kupita kwa anthu, kuchepetsa mlingo kungafunike. Ndipo ngati kusintha kwapangidwa kuchokera ku mitundu ina ya mankhwala, ndiye kuti kuyang'anira kuchipatala ndikofunikira. Kusamalidwa makamaka kuyenera kuchitika kuti kuwunikire kagayidwe kazachilengedwe m'masiku 14 atatha kusinthaku.
Insulin Bazal imayendetsedwa pansi pa khungu pakatha mphindi 45-60. musanadye, koma nthawi zina wodwalayo amapatsidwa jakisoni wa mu mnofu. Ndikofunika kudziwa kuti nthawi iliyonse komwe jekeseni adzayambitsa ayenera kusinthidwa.
Aliyense wodwala matenda ashuga ayenera kudziwa kuti insulini ya basal siigwiritsa ntchito mapampu a insulini, kuphatikizira okhazikika. Pankhaniyi, iv makonzedwe a mankhwala amatsutsana.
Kuphatikiza apo, mankhwalawa sayenera kukhala osakanikirana ndi ma insulin omwe amakhala ndi mawonekedwe osiyanasiyana (mwachitsanzo, 100 IU / ml ndi 40 IU / ml), mankhwala ena ndi ma insulin a nyama. Masautso a Basal Insulin mu vial ndi 40 IU / ml, kotero muyenera kugwiritsa ntchito syringes zapulasitiki zokha zomwe zimapangidwira mwachindunji kuzungulira uku kwa mahomoni. Komanso, syringe siyenera kukhala ndi zotsalira za insulin yakale kapena mankhwala ena.
Asanayambe kudya yankho kuchokera ku vial, ndikofunikira kuti atsegule phukusi pochotsa kapu ya pulasitiki. Koma, choyamba, kuyimitsidwa kuyenera kugwedezedwa pang'ono kuti isandulike oyera ndi mawonekedwe osasinthika.
Ngati mutagwedeza mankhwalawa ukakhalabe wowonekera kapena kuti pali zigamba kapena matope m'matumbo, ndiye kuti mankhwalawa ndi osavomerezeka. Poterepa, ndikofunikira kutsegula botolo lina lomwe lingakwaniritse zofunikira zonse pamwambapa.
Asanatolere insulini kuchokera phukusi, pamalowetsedwa mpweya wocheperako, kenako umayikidwa mu vial. Kenako phukusi limasinthidwa ndi syringe ndipo gawo lina la yankho limasonkhanitsidwa mmenemo.
Musanapange jakisoni, mpweya uyenera kumasulidwa ku syringe. Kuphatikiza khola kuchokera pakhungu, singano imayilowetsedwa, kenako yankho lake limalowa pang'ono. Pambuyo pake, singanoyo imachotsedwa mosamala pakhungu ndipo swab ya thonje imakanikizidwa kumalo opukutira masekondi angapo.
Ndemanga za anthu ambiri odwala matenda ashuga amatsimikiza kuti ma insulinge ndiwotsika mtengo koma ndizovuta kugwiritsa ntchito. Masiku ano, kuti athandizire kuchita njirayi, peniresi yapadera imagwiritsidwa ntchito. Ichi ndi chipangizo choperekera insulin chomwe chitha kupitilira zaka zitatu.
Cholembera cha basal GT choyambirira chimagwiritsidwa ntchito motere:
- Muyenera kutsegula chipangizocho, gwiritsitsani gawo lawo lamakina ndikukokera kapu kumbali.
- Wonyamula cartridge samachotsedwa ku makina ogwiritsa ntchito.
- Katoni imayikidwa mu chogwirizira, chomwe chimasungunuka kumbuyo (njira yonse) mpaka gawo loyenda.
- Asanayankhe yankho pansi pa khungu, cholembera chakecho chimayenera kutenthetsedwa pang'ono m'manja.
- Zovala zamkati ndi zamkati zimachotsedwa mosamala mu singano.
- Kwa katoni watsopano, jekeseni imodzi ndi magawo anayi; kuti muyike, muyenera kukoka batani loyambira ndikuzungulira.
- Singano (4-8 ml) ya cholembera imayikidwa molunjika pakhungu, ngati kutalika kwake ndi 10-12 mm, ndiye kuti singano imayikidwa pakona pa madigiri 45.
- Chotsatira, dinani modekha batani loyambalo la chipangizocho ndikulowetsa kuyimitsidwa mpaka kuwonekera, kuwonetsa kuti cholembera chatsika mpaka zero.
- Pambuyo pake, dikirani masekondi 10 ndikutulutsa singano kuchokera pakhungu.
Tsiku lokhazikitsidwa koyimitsidwa koyenera liyenera kulembedwa pamapepala olembedwa. Ndizofunikira kudziwa kuti mutatsegula kuyimitsidwa kumatha kusungidwa pamtunda wopitilira ma degree 25 kwa masiku 21 m'malo a mdima ndi ozizira.
Zotsatira zoyipa, contraindication, bongo
Insuman Bazal GT ilibe zotsutsana zambiri komanso zoyipa. Nthawi zambiri, zimachitika kuti munthu aliyense azichita tsankho. Pankhaniyi, edema ya Quincke, kupuma movutikira kumatha kukhazikika, ndipo totupa timawoneka pakhungu ndipo nthawi zina limayakasa.
Zotsatira zina zoyipa zimachitika makamaka ndi chithandizo cholakwika, osagwirizana ndi malangizo azachipatala kapena insulin. Muzochitika izi, wodwala nthawi zambiri amakhala ndi hypoglycemia, yomwe imatha kutsatiridwa ndi zovuta za NS, migraines, chizungulire ndi matenda ashuga komanso kuyankhula molakwika, masomphenya, kusazindikira komanso kukomoka.
Komanso, ndemanga za anthu odwala matenda ashuga akuti ngati atakhala ndi mlingo wochepa, kudya mosavutikira ndikulumpha jakisoni, hyperglycemia ndi matenda ashuga angachitike. Izi zimachitika limodzi ndi kupuma, kugona, kukomoka, ludzu, komanso kusowa kudya.
Kuphatikiza apo, khungu pakhungu la jakisoni limayakasa, ndipo nthawi zina limatupa. Kuphatikiza apo, kuwonjezereka kwa gawo la anti-insulin antibodies ndikotheka, chifukwa cha chomwe hyperglycemia imatha kukhazikika. Odwala ena amakumana ndi masinthidwe oyambukira ndimatumbo omwe amapanga thupi.
Ngati insulin yambiri, hypoglycemia ya zovuta zosiyanasiyana akhoza kukhala. Ndi mawonekedwe ofatsa, wodwalayo akazindikira, ayenera kumamwa chakumwa chokoma kapena kudya zomwe zili ndi chakudya. Pofuna kutaya chikumbumtima, 1 mg ya glucagon imabayidwa intramuscularly, ndi kusagwira kwake, njira ya glucose (30-50%) imagwiritsidwa ntchito.
Ndi hypoglycemia womwe umakhalapo kwa nthawi yayitali kapena pambuyo poti wa shuga, kulowetsedwa ndi njira yofowoka ya shuga ndikulimbikitsidwa, komwe kungapewe kuyambiranso.
Odwala ambiri amagonekedwa m'chipatala kuti ali ndi chiyembekezo chowunika.
Malangizo apadera
Insulin Bazal sayenera kugwiritsidwa ntchito ndi mankhwala angapo. Izi zimaphatikizapo mankhwala omwe ali ndi vuto la hypoglycemic, IAF, disopyramids, pentoxifylline, mimonoamine oxidase inhibitors, fluoxetine, fibrate, propoxyphene, mahomoni ogonana, anabolics ndi salicylates. Komanso, insulin ya basal sayenera kuphatikizidwa ndi Phentolamine, Cybenzoline, Ifosfamide, Guanethidine, Somatostatin, Fenfluramine, Phenoxybenzamine, Cyclophosphamide, Trophosphamide, Fenfluramine, sulfonamides, Tritokvalin, tetracyclines,
Ngati mumagwiritsa ntchito insulin yoyamba pamodzi ndi Isoniazid, Phenothiazine derivatives, Somatotropin, Corticotropin, Danazole, progestogens, glucocorticosteroids, Diazoxide, Glucagon, diuretics, estrogen, Isoniazid ndi mankhwala ena. Zomwezi zimapangidwanso ndi mchere wa lithiamu, clonidine ndi beta-blockers.
Kuphatikizika ndi ethanol kumafooketsa kapena kumatha mphamvu ya hypoglycemic. Akaphatikizidwa ndi Pentamidine, hypoglycemia imayamba, yomwe nthawi zina imakhala hyperglycemia. Ngati muphatikiza kugwiritsa ntchito insulin ndi mankhwala achifundo, ndiye kuti kufooka kapena kusakhalapo kwa Reflex activation ya NS achisoni ndikotheka.
Mlingo wa magulu ena a odwala amasankhidwa payekhapayekha. Chifukwa chake, odwala matenda ashuga okalamba komanso odwala hepatic, kulephera kwa impso, pakapita nthawi, kufunika kwa insulin kumachepa. Ndipo ngati mankhwalawa sanasankhidwe molondola, ndiye kuti odwala amatha kukhala ndi hypoglycemia.
Ndizofunikira kudziwa kuti ndi stenosis ya ubongo kapena ma coronary artery and proliferative retinopathy (pankhani yokhudzana ndi laser), ndikofunikira kuyang'anira mosamala kuchuluka kwa glycemia. Popeza, mu izi, kuchepa kwamphamvu kwa glucose kungayambitse kutayika kwathunthu.
Pa mimba, chithandizo cha Insuman Bazaol GT chiyenera kupitilizidwa. Ndikofunika kukumbukira kuti pambuyo pa trimester yoyamba, kufunika kwa insulini kudzawonjezeka. Koma pambuyo pobadwa kwa mwana, kufunika, m'malo mwake, kudzachepa, kotero kuti hypoglycemia mu shuga mellitus iwonekere ndikuwongolera insulin.
Munthawi ya mkaka wa m`mawere, mankhwala a insulin ayenera kupitilizidwa. Koma nthawi zina, kusintha kwa zakudya ndi mlingo kungakhale kofunikira.
Mtengo wa insulin Bazal umachokera ku 1228 mpaka 1600 rubles. Mtengo wa cholembera umakhala osiyanasiyana kuchokera pa 1000 mpaka 38 000 rubles.
Kanemayo m'nkhaniyi akuwonetsa momwe angabayire insulin moyenera.
