Gulu la insulin malinga ndi nthawi ya ntchito: tebulo ndi mayina

Insulin ndi mahomoni a protein-peptide omwe amapangidwa ndi maselo a pancreatic beta.

Molekyulu ya insulin m'mapangidwe ake imakhala ndi maunyolo awiri a polypeptide. Chingwe chimodzi chimakhala ndi ma amino acid 21, ndipo chachiwiri chimakhala ndi ma amino acid 30. Zomangira zimalumikizidwa pogwiritsa ntchito milatho ya peptide. Kulemera kwa molekyu ndi pafupifupi 5700. Pafupifupi nyama zonse, molekyulu ya insulini ndi yofanana, kupatula mbewa ndi makoswe, insulini mumakolo amanyama ndiosiyana ndi insulin mwa nyama zina. Kusiyana kwina pakati pa insulin mu mbewa ndikuti amapangidwa m'njira ziwiri.

Kufanana kwakukulu kwa kapangidwe kake ndi pakati pa insulin ya anthu ndi nkhumba.

Kukhazikitsidwa kwa ntchito za insulin kumachitika chifukwa cha kupezeka kwa kulumikizana kwake ndi ma receptor enaake omwe amapangidwira pamtunda wa membrane wa cell. Pambuyo poyanjana, insulin receptor tata imapangidwa. Zotsatira zovuta zimalowa mu cell ndikukhudza kuchuluka kwakukulu kwa kagayidwe kachakudya.

Pazinyama zoyamwitsa, ma insulin receptor amapezeka pafupifupi mitundu yonse yam'maselo momwe thupi limapangidwira. Komabe, maselo omwe akulimbana ndi ma cell, omwe ndi hepatocytes, myocyte, lipocytes, amatha kutengeka kwambiri ndi kupangika pakati pa receptor ndi insulin.

Insulin imatha kukopa pafupifupi ziwalo zonse ndi thupi lathu, koma zofunika kwambiri ndi minofu ndi minyewa ya adipose.

NdipoNsulin ndi gawo lofunikira la carbohydrate metabolism m'thupi. Hormayo imathandizira kutulutsa kwa glucose kudzera mu membrane wa maselo ndikugwiritsa ntchito kwake mkati mwa mkati.

Ndi gawo la insulin, glycogen imapangidwa m'maselo a chiwindi kuchokera ku glucose. Ntchito ina yowonjezera ya insulin ndikuponderezedwa kwa kuwonongeka kwa glycogen ndikusintha kwake kukhala glucose.

Pankhani yakuphwanya m'thupi la kapangidwe ka timadzi tating'onoting'ono, matenda osiyanasiyana amatuluka, omwe amachititsa kuti ashuga.

Pakakhala vuto la insulin m'thupi, makulidwe ake kuchokera kunja amafunikira.

Mpaka pano, akatswiri azamankhwala apanga mitundu ingapo ya komponiyi, yomwe imasiyana m'njira zambiri.

Mfundo za gulu la kukonzekera insulin

Zokonzekera zamasiku ano za insulin zomwe zimapangidwa ndi makampani opanga mankhwala padziko lonse lapansi zimasiyana m'njira zingapo. Zomwe zimapangitsa kuti gulu la insulin likhale ndi:

• chiyambi
• kuthamanga kolowera pakulowetsedwa mu thupi ndi kutalika kwa achire;
• kuchuluka kwa kuyeretsa kwa mankhwala ndi njira yodziyeretsera timadzi tambiri.

Kutengera ndi chiyambi, gulu la insulin limakonzekera:

1. Zachilengedwe - biosynthetic - Mankhwala achilengedwe opangidwa mwachilengedwe amapangidwa pogwiritsa ntchito zikondamoyo. Njira zoterezi zimapangidwira matepi a insulin GPP, ultralente MS. Actrapid insulin, insulrap SPP, monotard MS, semilent ndi ena amapangidwa pogwiritsa ntchito nkhumba kapamba.
2. Zopangira kapena mitundu ya mankhwala a insulin. Mankhwalawa amapangidwa pogwiritsa ntchito njira zopangira ma genetic. Insulin imapangidwa pogwiritsa ntchito ukadaulo wa DNA recombinant. Njirayi imapangitsa ma insulin monga actrapid NM, homofan, isofan NM, humulin, ultratard NM, monotard NM, etc.

Kutengera njira zakudziyeretsa komanso kuyera kwa mankhwala omwe amayambitsidwa, insulin imasiyanitsidwa:

• crystallized komanso osatchulidwa - ruppa imaphatikizapo ambiri a insulin yachikhalidwe. Zomwe zidapangidwa kale ku gawo la Russian Federation, pakadali pano gululi la mankhwala silipangidwa ku Russia;
• crystallized ndi osasefedwa ndi miyala, kukonzekera kwa gululi ndi kwamtundu umodzi kapena umodzi;
• crystallized ndikuyeretsedwa pogwiritsa ntchito ma gels ndi ion kusinthana ndi ma chromatography, ma monocomponent othandizira ali m'gulu lino.

Gulu la crystallized ndi kusefedwa ndi ma cell sieves and ion-exchange chromatography limaphatikizapo Actrapid, Insulrap, Actrapid MS, Semilent MS, Monotard MS ndi Ultralent MS insulins.

Magulu a mankhwala kutengera kuthamanga kwa isanayambike zotsatira zake ndi nthawi yayitali

Kugawika malinga ndi kuthamanga ndi kutalika kwa zochita za insulin zimaphatikizapo magulu otsatirawa a mankhwalawa.

Mankhwala osokoneza bongo omwe ali mwachangu komanso mwachidule. Gululi limaphatikizapo mankhwala monga Actrapid, Actrapid MS, Actrapid NM, Insulrap, Homorap 40, Insuman Rapid ndi ena ambiri. Kutalika kwa mankhwalawa kumayambira mphindi 15-30 pambuyo pa kumwa mankhwala kwa wodwala matenda a shuga. Kutalika kwa mankhwalawa kumawonedwa kwa maola 6-8 mutabadwa.

Mankhwala okhala ndi nthawi yayitali yochitapo kanthu. Gulu la mankhwalawa limaphatikizapo Semilent MS; - Humulin N, tepi ya Humulin, Homofan; - tepi, tepi ya MS, Monotard MS. Mankhwala omwe ali mgululi a insulin amayamba kugwira ntchito patatha maola 1-2 jekeseni, zotsatira za mankhwalawa zimatha kwa maola 12-16. Gululi limaphatikizaponso mankhwala monga Iletin I NPH, Iletin II NPH, Insulong SPP, insulin tepi GPP, SPP, yomwe imayamba kugwira ntchito patatha maola 2-4 jekeseni. Ndipo kutalika kwa nthawi ya insulin m'gulu lino ndi maola 20-24.

Mankhwala ovuta, omwe amaphatikiza ma insulin apakatikati ndi insulin yochepa. Ma protein omwe ali m'gululi amayamba kuchita mphindi 30 pambuyo pobweretsa matenda a shuga mthupi la munthu, ndipo nthawi yovuta imeneyi imachokera ku maola 10 mpaka 24. Kukonzekera kovuta kumakhala ndi Actrafan NM, humulin M-1; M-2; M-3; M-4, chiputu cha insuman. 15/85; 25/75; 50/50.

Mankhwala okhalitsa. Gawoli limaphatikizapo zida zamankhwala zomwe zimakhala ndi moyo wogwira ntchito m'thupi kuyambira maola 24 mpaka 28. Gululi la zida zamankhwala limaphatikizapo ultralente, ultralente NM, insulin super SPI, humulin ultralente, ultratard NM.

Kusankha kwa mankhwala ofunikira chithandizo kumachitika ndi endocrinologist chifukwa cha zotsatira za kuyesedwa kwa thupi la wodwalayo.

Makhalidwe aanthawi yochepa

Ubwino wogwiritsa ntchito ma insulin osakhalitsa ndi awa: zochita za mankhwalawa zimachitika mwachangu kwambiri, zimapereka chiwopsezo pamagazi ambiri ofanana ndi thupi, zochita za insulini sizakhalitsa.

Choipa cha mtundu uwu wa mankhwala ndi nthawi yochepa yochita zawo. Nthawi yochepa yofunikira imafunikira insulin mobwerezabwereza.

Zizindikiro zazikulu zakugwiritsira ntchito ma insulin osakhalitsa ndizotsatirazi:

1. Chithandizo cha anthu omwe amadwala matenda a shuga a insulin. Mukamagwiritsa ntchito mankhwalawa, kayendetsedwe kake ndi kosasangalatsa.
2. Chithandizo cha mitundu yayikulu ya odwala omwe alibe insulin amadalira achikulire.
3. Ngati wodwala matenda ashuga hyperglycemic chikachitika. Popanga mankhwala a mankhwalawa, mankhwalawa amaperekedwa pang'onopang'ono komanso kudzera m'mitsetse.

Kusankha kwa mlingo wa mankhwalawa ndi nkhani yovuta ndipo imachitika ndi endocrinologist. Mukafuna kudziwa kuchuluka kwake, muyenera kuganizira momwe thupi la wodwalayo lilili.

Njira imodzi yosavuta yowerengetsera kuchuluka kwa mankhwalawa ndikuti pa gramu ya shuga yomwe ili mkodzo, 1U ya mankhwala okhala ndi insulini iyenera kuyikidwa mthupi. Jakisoni woyamba wa mankhwala amachitika moyang'aniridwa ndi dokotala kuchipatala.

Kutalika kwa insulin mawonekedwe

Kapangidwe ka insulin ka nthawi yayitali kumaphatikizapo mapuloteni angapo oyambira ndi cholumikizira mchere, chomwe chimakupatsani mwayi wokhala ndi kuyamwa pang'onopang'ono komanso nthawi yayitali ya mankhwala m'thupi la wodwalayo.

Mapuloteni omwe amapanga mankhwalawa ndi protamine ndi globin, ndipo zovuta zimakhala ndi zinc. Kukhalapo kwa zinthu zowonjezera pakukonzekera kosavuta kumasinthira kanthu pachidwi cha mankhwala munthawi yake. Kuyimitsidwa kumatenga pang'onopang'ono, ndikupereka insulin yochepa m'magazi a wodwalayo kwanthawi yayitali.

Ubwino wogwiritsa ntchito mankhwala osakhalitsa

• kufunika kwa jekeseni ochepera m'thupi la wodwalayo;
• kupezeka kwa pH yayikulu mumankhwala kumapangitsa kuti jakisoni asamapweteke.

Zovuta zakugwiritsa ntchito gululi ndi:

1. kusowa kwa nsonga pogwiritsa ntchito mankhwalawa, omwe samalola kugwiritsa ntchito gululi la mankhwalawa pochiza mitundu yayikulu ya matenda ashuga, mankhwalawa amagwiritsidwa ntchito kokha pamitundu yofatsa;
2. Mankhwala saloledwa kulowa mitsempha, kuyambika kwa mankhwalawa mthupi ndi jekeseni wamkati kungayambitse kukula kwa embolism.

Masiku ano, pali mitundu yambiri ya mankhwala okhala ndi insulin. Kubweretsa ndalama kumachitika pokhapokha pobaya jekeseni wa subcutaneous.