Pamaso pa munthu aliyense wodwala matenda ashuga, posakhalitsa, funso lingabuke posankha njira yoyenera yogwiritsira ntchito insulin. Pharmacology yamakono imapereka jakisoni komanso mtundu wa piritsi wa timadzi timeneti.
Nthawi zina, osati kungokhala ndi chithandizo chamankhwala, komanso njira yofikira wodwala matenda ashuga itha kudalira kusankha koyenera.
Monga momwe zamankhwala zimasonyezera, kutumiza matenda ashuga ku jakisoni ndi ntchito yovuta. Izi zitha kufotokozedwa ndi kukhalapo kwa zikhulupiriro zambiri zabodza komanso malingaliro olakwika omwe amapezeka kuzungulira matendawa.
Ndizofunikira kudziwa kuti chodabwitsachi sichinadziwike pakati pa odwala okha, komanso pakati pa madokotala. Sikuti aliyense amadziwa kuti ndi insulin iti yabwino kwambiri.
Chifukwa chiyani tikufunika majakisoni?
Matenda a 2 a mtundu wa 2 amadziwika chifukwa cha kuchepa kwa kapamba komanso kuchepa kwa ntchito ya maselo a beta, omwe ali ndi udindo wopanga insulin.
Kuchita izi sikungakhudze magazi a glucose. Izi zitha kumveka chifukwa cha glycated hemoglobin, yomwe imawonetsa kuchuluka kwa shuga m'miyezi 3 yapitayi.
Pafupifupi onse odwala matenda ashuga ayenera kudziwa mosamala chizindikiro chake. Ngati achuluka moyenera malire (poyerekeza ndi chithandizo cha mapiritsi a nthawi yayitali), ndiye ichi ndichofunikira kuti amasulidwe a insulin.
Pafupifupi 40% ya odwala matenda ashuga a mtundu 2 amafunikira jakisoni wa insulin.
Achibale athu omwe ali ndi matenda a shuga, pitani jakisoni zaka 12 mpaka 15 atatha matendawa. Izi zimachitika ndi kuwonjezeka kwakukulu kwa shuga komanso kuchepa kwa hemoglobin ya glycated. Komanso kuchuluka kwa odwalawa kumawonjezera matendawa.
Madotolo amafotokozera njirayi mwakuthekera kopezeka pamiyezo yapadziko lonse lapansi, ngakhale kuli kwina kwamakono kwamakono. Chimodzi mwazifukwa zazikulu izi ndi kuwopa odwala matenda ashuga a jekeseni a moyo.
Ngati wodwala yemwe ali ndi matenda osokoneza bongo sakudziwa kuti insulin ndiyabwino, akukana kusintha jakisoni kapena kusiya, ndiye kuti amakhala ndi shuga wambiri. Mkhalidwe wotere ungayambitse kukula kwa zovuta pa thanzi ndi moyo wa munthu wodwala matenda ashuga.
Ma hormone osankhidwa bwino amathandizira kuti wodwalayo akhale ndi moyo wonse. Chifukwa cha zida zamakono zapamwamba zogwiritsidwanso ntchito, zidatha kuchepetsa kusasangalala komanso kupweteka kuchokera ku jakisoni.
Kulakwitsa kwa Matenda A shuga
Sikuti nthawi zonse mankhwalawa amalimbikitsa insulin mukamaliza kuphatikiza insulini yanuyomwe. Chifukwa china chingakhale izi:
- chibayo
- chimfine chovuta;
- matenda ena akulu owopsa;
- kulephera kugwiritsa ntchito mankhwala pamapiritsi (ndimomwe thupi limagwirira chakudya, mavuto a chiwindi ndi impso).
Kusunthira jakisoni kutha kuchitika ngati wodwala matenda ashuga akufuna kukhala moyo wabwino kapena, osatha kutsatira njira yokhazikika komanso yotsika ya carb yotsika.
Jekeseni sangathe mwanjira iliyonse yazaumoyo. Mavuto aliwonse omwe akanakhalapo pakubwera kwa jakisoni amathanso kungoona ngati mwangozi komanso mwangozi. Komabe, musataye nthawi yomwe pali insulin yambiri.
Chomwe chimapangitsa izi siziri insulini, koma kukhalapo nthawi yayitali ndimagazi osavomerezeka a shuga. Ayi, molingana ndi ziwerengero zamayiko osiyanasiyana, mukasinthana ndi jakisoni, nthawi yayitali yomwe munthu amakhala ndi moyo ndi kuchuluka kwake.
Ndi kuchepa kwa hemoglobin wa glycated ndi 1 peresenti, zovuta zotsatirazi zimachepa:
- myocardial infarction (mwa 14 peresenti);
- kudula kapena kufa (43 peresenti);
- michere yamavuto (37 peresenti).
Kutalika kapena kufupikitsa?
Pofuna kutsata secretion ya basal, ndichizolowezi kugwiritsa ntchito ma insulin omwe amatha kuwonetsa thupi nthawi yayitali. Mpaka pano, pharmacology ikhoza kupereka mitundu iwiri ya mankhwalawa. Izi zitha kukhala insulin ya nthawi yayitali (yomwe imagwira ntchito mpaka maola 16 kuphatikiza) komanso kuwonetsa nthawi yayitali (nthawi yayitali kuposa maola 16).
Mahomoni a gulu loyamba amaphatikizapo:
- Gensulin N;
- Humulin NPH;
- Insuman Bazal;
- Protafan HM;
- Biosulin N.
Kukonzekera kwa gulu lachiwiri:
- Tresiba;
- Levemir;
- Lantus.
Levemir ndi Lantus amasiyana kwambiri ndi mankhwala ena onse chifukwa amakhala ndi nthawi yosiyanitsidwa ndi thupi la odwala matenda ashuga ndipo amawonekeratu. Insulin ya gulu loyamba ndi yoyera matope. Asanagwiritse ntchito, zomwe zimagwiritsidwa ntchito ndi iwo ziyenera kugulitsidwa mosamala pakati pa kanjedza kuti mupeze yankho lofanana ndi mitambo. Kusiyana kumeneku ndi chifukwa cha njira zosiyanasiyana zopangira mankhwala.
Ma insulini ochokera pagulu loyamba (nthawi yayitali) ndiwopamwamba. Mwanjira ina, nsanja ya chisautso imatha kuyambika pakuchita kwawo.
Mankhwala ochokera ku gulu lachiwiri samadziwika ndi izi. Ndizinthu izi zomwe ziyenera kukumbukiridwa posankha mulingo woyenera wa insulin. Komabe, malamulo apadera a mahomoni onse ndi ofanana.
Kuchuluka kwa insulin yowonekera kwa nthawi yayitali kuyenera kusankhidwa kuti athe kusunga shuga wamagazi pakati pa chakudya mkati moyenera. Mankhwala amaphatikizapo kusinthasintha pang'ono pamtunda kuchokera pa 1 mpaka 1.5 mmol / L.
Ngati mlingo wa insulini udasankhidwa bwino, ndiye kuti magazi a m'magazi sayenera kugwa kapena kuchuluka. Chizindikiro ichi chiyenera kuchitika kwa maola 24.
Insulin yotalikilapo iyenera kubayidwa mosakakamiza ku ntchafu kapena m'khutu. Chifukwa chakufunika koyamwa mosavuta komanso pang'onopang'ono, jakisoni m'manja ndi m'mimba ndizoletsedwa!
Zilonda m'malo awa zimapereka zotsatirazi. Insulin yochepa-yoika, yomwe imagwiritsidwa ntchito pamimba kapena mkono, imapereka chiwongola dzanja chokwanira panthawi yomwe imayamwa chakudya.
Momwe mungaswe usiku?
Madokotala amalimbikitsa kuti odwala matenda ashuga ayambe jekeseni wa insulin nthawi yayitali. Komanso, onetsetsani kuti mukudziwa komwe mungabayire insulin. Ngati wodwalayo sakudziwa momwe angachitire izi, ayenera kumwedwa mosiyanasiyana maola atatu aliwonse:
- pa 21.00;
- pa 00.00;
- pa 03.00;
- nthawi ya 06.00.
Ngati nthawi iliyonse wodwala yemwe ali ndi matenda ashuga amatha kulumikizana ndi zizindikiro za shuga (utachepa kapena kuwonjezeka), ndiye pamenepa, mlingo womwe ukugwiritsidwa ntchito uyenera kusintha.
Muzochitika zoterezi, ziyenera kukumbukiridwa kuti kuwonjezeka kwa glucose sikuti nthawi zonse kumachitika chifukwa cha kuchepa kwa insulin. Nthawi zina izi zimatha kukhala umboni wa latent hypoglycemia, yomwe yamveka ndi kuwonjezeka kwa glucose.
Kuti mumvetsetse chifukwa cha kuchuluka kwa shuga usiku, muyenera kuganizira bwino nthawi yonseyo. Poterepa, pakufunika kuwunika kuchuluka kwa glucose kuyambira 00.00 mpaka 03.00.
Ngati pakhala kuchepa mkati mwake munthawiyi, ndiye kuti pali chifukwa chotchedwa "pro-bending" chobisika. Ngati ndi choncho, ndiye kuti kuchuluka kwa insulin ya usiku kuyenera kuchepetsedwa.
Aliyense endocrinologist anganene kuti chakudya chimakhudza kwambiri kuwunika kwa insulin yoyamba mthupi la odwala matenda ashuga. Kuyerekeza kolondola kwambiri kwa kuchuluka kwa insulin ya basal kumatheka pokhapokha palibe shuga m'magazi omwe amabwera ndi chakudya, komanso insulini yokhala ndi nthawi yayitali.
Pachifukwa ichi, musanayese insulin yanu usiku, ndikofunikira kudumphira chakudya chanu chamadzulo kapena kudya chakudya chamadzulo kwambiri kuposa masiku onse.
Ndikwabwino kusagwiritsira ntchito insulin yayifupi kuti musakhale ndi chithunzi chowoneka bwino cha dziko.
Kuti mudziyang'anire, ndikofunika kusiya kumwa mapuloteni ndi mafuta nthawi yamadzulo komanso musanayang'ane shuga. Ndikwabwino kupatsa chidwi ndi zinthu zamafuta.
Izi ndichifukwa choti mapuloteni ndi mafuta amalowetsedwa ndi thupi pang'ono pang'onopang'ono ndipo amatha kuwonjezera kwambiri kuchuluka kwa shuga usiku. Mkhalidwewo, umakhala cholepheretsa kupeza zotsatira zoyenera za insulin ya usiku.
Masana masana
Poyesa insulin ya masana masana, imodzi mwa chakudya siyiyenera kuyikidwa kunja. Mwabwino, mutha kukhala ndi njala tsiku lonse, kwinaku mukuyesa kuchuluka kwa glucose ola limodzi. Izi zimapereka mwayi wowona bwino nthawi yakuchepetsa kapena kuwonjezera shuga.
Kwa ana aang'ono, njira yodziwira matenda sioyenera.
Pankhani ya ana, insulin yoyambira iyenera kuwunikiranso pa nthawi yodziwika. Mwachitsanzo, mutha kudumphira chakudya cham'mawa ndikuwayeza kuchuluka kwa magazi ola lililonse:
- kuyambira pomwe mwana adzuka;
- popeza jakisoni wa insulin yofunika.
Amapitilizabe miyeso musanadye chakudya chamadzulo, ndipo atatha masiku angapo muyenera kulumphira nkhomaliro, kenako ndi chakudya chamadzulo.
Pafupifupi insulin yonse yowonjezereka iyenera kubayidwa kawiri pa tsiku. Chosiyana ndi mankhwala a Lantus, omwe amalowetsedwa kamodzi patsiku.
Ndikofunika kukumbukira kuti ma insulin onse omwe ali pamwambapa, kupatula Lantus ndi Levemir, ali ndi mtundu wa pobisalira. Monga lamulo, nsonga za mankhwalawa zimachitika mkati mwa maola 6-8 kuchokera nthawi yomwe imayamba kuwonekera.
Panthawi zapamwamba, kutsika kwa shuga m'magazi kumatha kuchitika. Izi ziyenera kukonzedwa ndi ufa waung'ono wa mikate.
Madokotala amalimbikitsa kubwereza cheke cha basal insulin pakusintha kulikonse. Ndikokwanira masiku atatu kuti mumvetsetse mphamvu imodzi. Kutengera ndi zotsatira zake, dokotala adzalembera zoyenera kuchita.
Kuti mupeze insulini yatsiku ndi tsiku ndikumvetsetsa kuti insulin ndiyabwino, dikirani maola 4 kuchokera pachakudya chanu chapita. Nthawi yoyenera imatha kutchedwa maola 5.
Odwala omwe ali ndi matenda ashuga omwe amagwiritsa ntchito insulin yayifupi ayenera kupirira nthawi yoposa maola 6-8:
- Gensulin;
- Humulin;
- Khalid.
Izi ndizofunikira chifukwa cha zinthu zina zomwe zimapangitsa kuti inshuwaransi ipangidwe thupi la wodwala. Ma Ultrashort insulins (Novorapid, Apidra ndi Humalog) samvera lamuloli.
