Ku Russian Federation, pafupifupi 45 peresenti ya anthu omwe amapezeka ndi matenda a shuga amagwiritsa ntchito mankhwala a insulin m'miyoyo yawo yonse. Kutengera ndi mtundu wa mankhwala, dokotala amatha kukupatsani insulin yochepa, yapakati komanso yayitali.
Mankhwala othandizira odwala matenda ashuga ndi ma insulini apakati. Hormone yotere imayendetsedwa kamodzi kapena kawiri pa tsiku.
Popeza mayamwidwe akumwa mankhwalawa amachedwa kwambiri, zotsatira za hypoglycemic zimayamba ola limodzi ndi theka pambuyo poti mwabayidwa.
Mitundu ya insulin
- Kuchita zinthu mwachangu insulin kumayamba kuchepetsa shuga m'magazi mphindi 15-30 pambuyo pakulowetsedwa m'thupi. Kuchuluka kwambiri m'magazi kumatha kuchitika pambuyo pa ola limodzi ndi theka mpaka maola awiri, pafupifupi, insulin yotere imatha kuchita kuyambira maola 5 mpaka 8.
- Kutalika kwapakati-insulin kumatsitsa shuga m'magazi amodzi ndi theka mpaka maola awiri atatha kupangidwa. Pazipita kuchuluka kwa zinthu m'magazi zimawonedwa pambuyo maola 5-8, mphamvu ya mankhwalawa imatha kwa maola 10-12.
- Hemidulini yomwe imagwira ntchito kwa nthawi yayitali imagwira ntchito maola awiri kapena anayi pambuyo popereka thupi. Mulingo wokulirapo wa kuchuluka kwa chinthu m'magazi umawonedwa pambuyo pa maola 8-12. Mosiyana ndi mitundu ina ya insulin, mankhwalawa amagwira ntchito tsiku limodzi. Palinso ma insulin omwe ali ndi vuto la hypoglycemic kwa maola 36.
Komanso, insulin, kutengera njira yoyeretsera, imatha kukhala yachilendo, yopanga monopic ndi monocomponent. Mwa njira yokhazikika, kuyeretsedwa kumachitika pogwiritsa ntchito chromatografia, monopic nsonga ya insulin imapezeka ndikudziyeretsa ndi gel chromatography. Kwa insulin yokhazikika, ion-exchange chromatography imagwiritsidwa ntchito poyeretsa.
Mlingo wa kuyeretsa umaweruzidwa ndi kuchuluka kwa ma proinsulin particles miliyoni miliyoni a insulin. Kuchita kwa insulin nthawi yayitali kumatheka chifukwa chakuti timadzi ta mankhwalawa timapatsidwa chithandizo chapadera ndipo mapuloteni ndi zinc amawonjezeredwa.
Kuphatikiza apo, ma insulins amagawidwa m'magulu angapo, kutengera njira yomwe akonzekera. Insulin yozizira yaumunthu imapezeka ndi kaphatikizidwe ka bakiteriya ndi semisynthesis ku kapamba wa nkhumba. Hulinologous insulin imapangidwa kuchokera ku zikondamoyo za ng'ombe ndi nkhumba.
Semi-yopanga insulin yamunthu imapezeka ndikusintha amino acid alanine ndi threonine. Insulin yotere imakonda kugwiritsidwa ntchito ngati wodwala matenda ashuga akukana insulin, mankhwala ena osokoneza bongo.
Insulin Yapakatikati
Kuchuluka kwakukulu kumatha kuchitika pambuyo pa maola 6-10. Kutalika kwa ntchito ya mankhwalawa zimatengera Mlingo wosankhidwa.
Makamaka, mukamayambitsa magawo a 8-12 a mahomoni, insulin idzakhala yogwira ntchito kwa maola 12-14, ngati mugwiritsa ntchito mlingo wa 20-25, mankhwalawa amatha maola 16-18.
Kuphatikiza kwakukulu ndikuthekera kwa kusakanikirana kwa mahomoni ndi insulin yofulumira. Kutengera kapangidwe ndi kapangidwe kake, mankhwalawa ali ndi mayina osiyanasiyana. Odziwika bwino ndi ma insulins a nthawi yayitali:
- Insuman Bazal,
- Biosulin N,
- Berlinsulin-N basal,
- Homofan 100,
- Protofan NM,
- Humulin NRH.
Komanso pamashelefu ammalo ogulitsa mankhwala, mankhwala amakono opangira Russian Brinsulmi-di ChSP amaperekedwa, omwe ali ndi kuyimitsidwa kwa insulin ndi protamine.
Ma insulini apakatikati apakati amasonyezedwa kwa:
- Mtundu 1 wa shuga;
- Type 2 matenda a shuga;
- Pankhani ya zovuta za shuga mu mawonekedwe a ketoacidosis, acidosis;
- Ndi chitukuko cha matenda oopsa, matenda wamba, opaleshoni yayikulu, nthawi yothandizira, zoopsa, zovuta za odwala matenda ashuga.
Kugwiritsa ntchito mahormone
Kuvulala kumachitika m'mimba, ntchafu. Zotsogola, matako. Mlingo umatsimikiziridwa payekhapayekha, malinga ndi lingaliro la adokotala. Mothandizidwa ndi mtsempha wa magazi amaloledwa.
Ndikofunikira kutsatira malingaliro onse a dokotala pakusankha mtundu wa mahomoni, mlingo komanso nthawi yodziwikiratu. Ngati munthu wodwala matenda ashuga amasunthika kuchokera ku nkhumba kapena ng'ombe ya insulin kupita kwa munthu wofananayo, kusintha kwa mankhwala kumafunika.
Asanayambitse mankhwalawa, vial amayenera kugwedezeka pang'ono kuti zosungunulira zisakanikirane kwathunthu komanso mawonekedwe amadzimadzi. Mlingo wofunika wa insulin umakokedwa nthawi yomweyo ndikulowetsa.
Simungathe kugwedeza mwamphamvu botolo kuti chithovu chisawonekere, izi zitha kusokoneza kusankha kwa mulingo woyenera. Syringe ya insulin iyenera kufanana ndi kuchuluka kwa mahomoni omwe amagwiritsidwa ntchito.
Asanayambitse insulin, tsamba la jakisili silifunikira kuzunzidwa. Ndikofunikira kusintha mawebusayiti enanso. Kusamalidwa kuyenera kuchitika kuti zitsimikizidwe kuti singano siyalowa m'mitsempha yamagazi.
- Makonzedwe a insulin mu matenda a shuga amachitika 45-60 Mphindi pamaso chakudya kawiri pa tsiku.
- Odwala achikulire omwe mankhwalawo amaperekedwa kwa nthawi yoyamba ayenera kulandira mlingo woyambirira wa magawo 8-24 kamodzi patsiku.
- Pamaso pa kukhudzika kwakukulu kwa mahomoni, ana ndi akulu amawongolera osaposa magawo 8 patsiku.
- Ngati kukhudzika kwa mahomoni kumachepetsedwa, amaloledwa kugwiritsa ntchito Mlingo wamagulu opitilira 24 patsiku.
- Mlingo umodzi umodzi ukhoza kukhala 40 mayunitsi. Kuchulukitsa izi ndizotheka pokhapokha pangozi yadzidzidzi.
Kutalika kwa insulin kungagwiritsidwe ntchito molumikizana ndi insulin yochepa. Pankhaniyi, insulin yothamanga imasonkhanitsidwa koyamba mu syringe. Jakisoni amachitidwa nthawi yomweyo mankhwala atasakanikirana.
Pankhaniyi, ndikofunikira kuyang'anira kapangidwe ka insulin, popeza ndizoletsedwa kusakaniza kukonzekera kwa zinc ndi mahomoni okhala ndi phosphate.
Musanagwiritse ntchito mankhwalawa, vala uyenera kuyang'aniridwa mosamala. Ngati ma flakes kapena tinthu tina tomwe timaphatikizika tikasakaniza, insulini simalola. Mankhwalawa amaperekedwa malinga ndi malangizo omwe amaphatikizidwa ndi cholembera. Kuti mupewe zolakwika, dokotala ayenera kukuphunzitsani momwe mungagwiritsire ntchito chipangizocho kulowa mu mahomoni.
Amayi omwe amapezeka ndi matenda a shuga nthawi ya bere ayenera kuwunika magazi awo. Munthawi iliyonse ya mimba, ndikofunikira kusintha mlingo, kutengera zosowa za thupi.
Komanso, kusintha kwa muyezo wa timadzi timene kumafunikira pakuyamwa.
Contraindication ndi bongo
Ndi mlingo wolakwika, wodwalayo amatha kuona zizindikiro za hypoglycemia monga thukuta lozizira, kufooka kwambiri, khungu, khungu, mtima, kunjenjemera, mantha Munthu amatha kudwala matenda osokoneza bongo.
Ngati hypoglycemia yofatsa kapena yolimbitsa thupi imawonedwa, wodwalayo ayenera kulandira shuga wambiri mu mapiritsi, msuzi wa zipatso, uchi, shuga ndi zinthu zina zomwe zimakhala ndi shuga.
Ngati matenda oopsa a hypoglycemia apezeka, munthu amayamba kuzindikira kapena ali ndi vuto lakumiseche, 50 ml ya 50% ya glucose jekeseni mwachangu kwa wodwalayo. Chotsatira ndi kulowetsedwa kosalekeza kwa 5% kapena 10% yamadzimadzi amadzimadzi. Nthawi yomweyo, zizindikiro za shuga, creatinine, ndi urea m'magazi zimayang'aniridwa.
Wodwalayo akayambanso kuzindikira, amapatsidwa chakudya chambiri chopatsa mphamvu kuti asayambenso kuwonongeka ndi hypoglycemia.
Kutalika kwapanthawi insulin imaphatikizidwa mu:
- hypoglycemia;
- insuloma;
- Hypersensitivity kwa timadzi ta insulin kapena chilichonse cha mankhwala.
Ndikofunikira kudziwa kuti mankhwalawa amatha kuyambitsa mavuto omwe nthawi zambiri amapezeka ndimankhwala osokoneza bongo, zosiyidwa kapena zakudya zochepa, kulimbitsa thupi kwambiri, ndikupanga matenda oyambitsidwa ndi matenda. Pankhaniyi, zizindikirazi zimayendera limodzi ndi hypoglycemia, matenda amitsempha, kunjenjemera, zovuta za kugona.
Zotsatira zoyipa zimawonedwa ngati wodwalayo amakhala ndi chidwi chofuna kudziwa zambiri za insulin. Wodwalayo amatha kupuma movutikira, anaphylactic, kuzizira pakhungu, kutupa kwa larynx, kupuma movutikira. Vuto lalikulu la chifuwa limatha kuyika moyo wa munthu pangozi.
Ngati mankhwalawa amagwiritsidwa ntchito kwanthawi yayitali, lipodystrophy imatha kuwoneka pamalo a jakisoni wa insulin.
Ndi hypoglycemia, chidwi cha anthu nthawi zambiri chimachepa ndipo kuthamanga kwa psychomotor reaction kumachepa, motero, panthawi yopulumutsa simuyenera kuyendetsa galimoto kapena kuyendetsa njira zazikulu.
Kuchita ndi mankhwala ena
Zoyimitsa, zomwe zimaphatikizapo zinc, siziyenera konse kusakanikirana ndi insulini wokhala ndi phosphate, kuphatikiza kuti siziphatikizidwa ndi kukonzekera kwina kwa insulin.
Mukamagwiritsa ntchito mankhwala ena, muyenera kufunsa dokotala, chifukwa mankhwala ambiri angakhudze kupanga kwa shuga.
Kukulitsa mphamvu ya hypoglycemic ya insulin ya mahomoni ndikuchulukitsa chiopsezo cha hypoglycemia mankhwala monga:
- manzeru
- monoamine oxidase zoletsa
- othandizira pakamwa
- ifosfamides, alpha-blockers,
- sulfonamides,
- angiotensin otembenuza enzyme zoletsa,
- tritoxylin,
- disopyramids
- mafupa
- onjezerani
- fluoxetines.
Komanso, pentoxifyllines, propoxyphenes, salicylates, amphetamines, anabolic steroids, ndi triphosphamides amachitanso chimodzimodzi.
Limbikitsani kapena kufooketsa mphamvu ya hypoglycemic ya mah salicylates, mchere wa lithiamu, beta-blockers, reserpine, clonidine. Momwemonso zimakhudza thupi ndi zakumwa zoledzeretsa.
Ma diuretics, glucocorticosteroids, sympathomimetics, njira zakulera pakamwa, antidepressants atatu amatha kufooketsa insulin.
Mu kanema munkhaniyi, zambiri za Protafan insulin zimaperekedwa mwatsatanetsatane.
