Mtundu 1 ndi mtundu 2 shuga wa insulin

Nthawi yoyamba insulini idagwiritsidwa ntchito bwino pochiza matenda ashuga ka 1922. Kuyambira nthawi imeneyo, mankhwala a insulini apulumutsa miyoyo ya anthu mamiliyoni ambiri. Chaka chilichonse, kukonzekera, njira ndi kayendetsedwe ka kayendetsedwe kake zimakonzedwa. Tsopano mitundu yoposa 50 ya insulin ikupangidwa, ndipo kupanga zatsopano, zothandiza kwambiri ndikupitirirabe.

Cholinga cha mankhwala a insulini ndikusunga kagayidwe kazakudya kam'mimba pafupi kwambiri ndi zomwe zimaperekedwa mwachilengedwe. Kuti muchite izi, ndikofunikira kuti musangobweretsera kukonzekera kwa insulin m'magazi momwe mungathere pakubisika kwachilengedwe kwa hormone iyi, komanso kukhalabe ndi zizindikiro zabwino kwa nthawi yayitali, nthawi zambiri kwazaka zambiri.

Kodi chithandizo cha insulin ndi chofunikira nthawi ziti?

Mankhwala a insulini sagwiritsidwa ntchito pokhapokha ngati wodwala yemwe ali ndi insulin kwathunthu kulibe, komanso pancreas ikakhala kuti palibe, ndipo mankhwala ochepetsa shuga sagwira ntchito. Pakanthawi, insulini imalembedwa kwakanthawi kochulukitsa. Pakadali pano, pafupifupi 30% ya anthu odwala matenda a shuga amadzipaka okha ndi insulin.

Matenda a shuga ndi kupsinjika kudzakhala chinthu chakale

• Matenda a shuga -95%
• Kuthetsa kwa mitsempha thrombosis - 70%
• Kuthetsa kwa kugunda kwamtima kwamphamvu -90%
• Kuthana ndi kuthamanga kwa magazi - 92%
• Kuwonjezeka kwa mphamvu masana, kukonza kugona usiku -97%

Zisonyezo za mankhwala a insulin:

1. Mtundu wa 1 wa matenda ashuga, mosatengera kutalika kwa matenda komanso zaka za wodwalayo.

2. Matenda oopsa a hyperglycemic (ketoacidosis, chikomokere).

3. Matenda a 2 a shuga ngati chithandizo chanthawi zonse sichingatheke:

• ngati kusakhazikika kwa zakudya zama carb otsika ndi ma hypoglycemic othandizira pazokwanira zovomerezeka kumatsimikiziridwa;
• ngati pali contraindication kumwa mankhwala ochepetsa shuga: sayanjana zimachitika, aimpso ndi kwa chiwindi insufficiency, magazi matenda;
• pa mimba ndi yoyamwitsa.

4. Kuphatikiza kwa shuga ndi matenda ena:

• Kuchepetsa thupi pazomwe zili bwino, ngakhale kuyambitsa;
• matenda am'mimba ndi malabsorption;
• matenda oopsa otupa, makamaka purulent;
• kuyambiranso kwa matenda osachiritsika;
• myocardial infarction;
• othandizira opaleshoni.

5. Zovuta zingapo za matenda ashuga:

• diabetesic neuropathy, limodzi ndi kupweteka kwambiri ndikuchepetsa kwambiri moyo;
• odwala matenda ashuga phazi lokhala ndi zilonda kapena zilonda zam'mimba;
• angiopathy, yomwe imasokoneza magwiridwe antchito a chiwalo chilichonse, mpaka kuchepa kwake;
• mkulu triglycerides (> 5.6) wophatikizana ndi pafupipafupi hyperglycemia.

Pancreatic resection ngati maselo a beta amakhudzidwa kwambiri.

Kodi phindu la mankhwala a insulin ndi chiyani?

Nthawi zambiri, chithandizo cha insulin chovomerezeka cha matenda amtundu woyamba sichimakhudzidwa ndi odwala, popeza ndi njira yokhayo yomwe ingagwiritsidwe ntchito. Matenda amtunduwu amadziwika ndi kusowa kwathunthu kwa insulin mthupi, popanda mahomoni awa, shuga kuchokera m'magazi sangathe kulowa m'maselo. Zotsatira zake, minofu imamwalira ndi njala, ndipo kapangidwe kake ka magazi kamasintha kwambiri, kamene kamapangitsa munthu kuti akhale chikomokere, nthawi zambiri ketoacidotic.

Njira zina zonse zotsatsa, monga sopo kapena masentimita, sizingayambitse kupanga kwa insulin. Kulimbikitsa njira zamatenda a shuga zimaphatikizanso kubzala mu maselo akuluakulu a beta komanso kuponyera kwa pancreatic. Tsopano sizigwiritsidwa ntchito pagulu, chifukwa akupanga chitukuko.

Mtundu wachiwiri wa matenda ashuga a mellitus, mutazindikira matenda, insulini imafunikira 5-10% ya odwala matenda ashuga, pambuyo zaka 10 - 80%. Tsoka ilo, kukonzekera kwa insulin kumayambitsa mantha kwa odwala, chifukwa chake akuyesera ndi mphamvu zawo zonse kuti achedwetse kuyamba kwa jakisoni. Nthawi zambiri izi zimachitika chifukwa cha thanzi la munthu. Zinakhazikitsidwa kuti ndikofunikira kusinthira ku insulin ngati glycated hemoglobin ili> 7 pogwiritsa ntchito njira zachikhalidwe.

Kukhazikitsidwa kwa insulin panthawiyi kumatha kuchepetsa kwambiri zovuta za matenda ashuga, komanso kuimitsa, ndipo nthawi zina zimatha kusintha, kupitirira kwawo. Odwala omwe ali ndi mankhwala a insulin sakhala ndi mwayi wodziwika kwambiri wa hyperglycemia, amakhala akhama komanso amagwira ntchito nthawi yayitali. Potengera kukonzekera kwa insulin, kubisala kwawo kwa mahomoni awo kumalimbikitsidwa.

Kugwiritsa ntchito moyenera mankhwala amakono kumapangitsa kukhala ndi shuga wabwinobwino, kupewa hypoglycemia, komanso kuwonjezera thupi. Ma syringe pensulo ndi singano zazifupi zoperewera zimakupatsani mwayi kuti mupange jakisoni popanda vuto. Majakisoni sayenera kuchitidwa pafupipafupi monga momwe amachitira odwala matenda ashuga 1, jakisoni wa insulin patsiku wokwanira.

Mitundu ndi iti

Masiku ano, njira ziwiri za utsogoleri wa insulin ndizodziwika: chikhalidwe komanso champhamvu, kapena chamoyo, cholimbitsa.

Chithandizo cha insulin chachikhalidwe chimadalira Mlingo wa mankhwalawa, omwe amawerengedwa ndikusinthidwa ndi dokotala. Wodwalayo amangolowetsa muyezo woyenera wa mankhwala panthawi. Amatha kuyendetsa shuga m'magazi pothandizidwa ndi chakudya: kuchepetsa kuchuluka kwa chakudya chambiri kuti muchepetse shuga, kuchuluka ndi hypoglycemia. Monga lamulo, zotsatira za kuwongolera kotereku sikutalikirana kwambiri ndi magazi. Pakadali pano, makulidwe a insulin kuonedwa ngati wopanda ntchito ndipo amangogwira ntchito kwa odwala omwe sangathe kuwerengera kapena kumwa mankhwala.

Zotsatira za insulin therapy ndizabwino kwambiri. Mwachitsanzo, chiopsezo cha retinopathy chimachepetsedwa ndi 76%, neuropathy - 60%. Izi ndichifukwa choti ili pafupi kwambiri ndi chilengedwe zachilengedwe cha mahomoni. Chomwe chimapangidwira pakupanga insulin ndi ma jakisoni angapo omwe amatsitsa kupangika kwa mahomoni ambiri ndikuwonjezera kaphatikizidwe kamayankho a glucose omwe amalowa m'magazi, ndikuwunika kwambiri shuga ndi glucometer. Zakudya zopatsa insulin mankhwala sizofunikira.

Njira yamakono kwambiri yoperekera insulin m'mwazi mu shuga ndi pampu ya insulin. Ichi ndi chipangizo chomwe chitha kuyambitsa payokha khungu pakhungu pama microdoses, ndikumaperekedwa pafupipafupi. Ndi mankhwala, wodwalayo amatha kulowa muyezo woyenera wa mankhwala musanadye. Zipangizo zamakono zimatha kuyang'anira kuchuluka kwa shuga okha ndikuchenjeza zikafika mopitilira muyeso. Therapy yolimba ya insulin yolimba imapereka chindapusa cha shuga chambiri poyerekeza ndi mitundu ina, koma imafunikira kusamala mosamala ndi chipangizocho ndi kuwongolera kwina kwa glucose. Zovuta zake zimapangidwanso chifukwa cha singano yoperekera insulin pafupipafupi mthupi.

• Nkhani yathu ya momwe mungawerengere kuchuluka kwa insulin - werengani apa

Zomwe amagwiritsidwa ntchito komanso mankhwala

Ma regular odziwika bwino a mankhwalawa sagwiritsidwa ntchito nthawi zonse. Mankhwalawa ana ndi amayi apakati, Mlingo, mfundo zoyambitsa ndi kuyendetsa glycemia ndizosiyana. M'magulu awa, insulin sensitivity imasintha nthawi zonse, kotero odwala amafunikira kuyang'aniridwa mosamalitsa. Ili ndi mawonekedwe ake komanso kugwiritsa ntchito insulin kwa odwala omwe ali ndi matenda amisala.

Mu ana

Ana, gawo lalikulu la maphunziro a shuga ndi chizolowezi cha hypoglycemia pochiza insulin. Kuphatikiza apo, madontho a shuga omwe amakhala nawo nthawi zambiri amakhala oopsa kwa iwo kuposa achikulire, chifukwa amasokoneza kukula kwa malingaliro, mkhalidwe wowonda, kusokoneza mayendedwe, komanso kusokoneza kuphunzira ndi kulumikizana ndi anzawo.

Pofuna kuchepetsa kuchuluka kwa hypoglycemia, zigonjetso zapamwamba zakhazikitsidwa mu diabetesology ya ana: shuga ya ≤ 8 mmol / L, glycated hemoglobin <8.

Kufunika kwa insulin pa kilogalamu yolemetsa kumakhala kwa mwana aliyense payekhapayekha ndipo kumatha kusiyanasiyana pafupifupi kawiri pa nthawi zosiyanasiyana zomwe anakula: zochepa paubwana komanso ukalamba, makamaka panthawi yakutha.

Ana osakwana zaka 2 amafunsidwa mankhwala amtundu wa insulin. Ngati ipereka zotsatira zabwino, kugwiritsidwa ntchito kwake kungawonjezeke mpaka kutha msinkhu. Kuyambira ndili ndi zaka 12, pulogalamu yolimbikitsidwa imalimbikitsidwa. Pang'onopang'ono, ana amaphunzira kubaya mahomoni awoawo, kuyeza shuga komanso kuwerengetsa mlingo. Potere, ulamuliro wa makolo ukufunika.

Pa nthawi yoyembekezera

Shuga wambiri mwa amayi apakati amatsogolera ku fetal fetopathy, yomwe imaphatikizapo ma pathologies a mkati, mantha amthupi, komanso kagayidwe. Kukula mwachizolowezi kwa mwana kumatheka pokhapokha ngati wodwala amakhala ndi shuga, chifukwa chake, zomwe zikuwonetsa kuchuluka kwa shuga mwa amayi oyembekezera ndi okhwima: 3.3-5.1, okwera 5.6 mmol / L.

Kodi mankhwala a insulin amasintha bwanji panthawi yapakati:

• Mtundu 1. Kusinthasintha kwapafupipafupi pazofunikira za insulin kumawonedwa, kotero shuga wabwinobwino amatha kuchitika pang'onopang'ono powunikira mosamala komanso kusintha pafupipafupi kwa mlingo. Mumakonda mankhwala a insulin.
• Mtundu 2. Ndondomeko ya mankhwalawa imasintha kwambiri, chifukwa nthawi yomwe mayi ali woyembekezera, amachepetsa mankhwala. Njira yokhayo yodalirika panthawi imeneyi ndi insulin. Nthawi zambiri, njira yachikhalidwe imakwanira kubwezeredwa mwabwinobwino. Ndikofunika kusintha kusinthira kwa insulin mankhwala mukakonzekera.
• Matenda a shuga. Mukamapereka mankhwala, kuchuluka kwa shuga kumawerengedwa. Kubaya jakisoni musanadye nthawi zambiri kumakhala kokwanira, koma muzovuta, chithandizo cha insulin chambiri chitha kugwiritsidwa ntchito. Werengani zambiri za matenda a shuga pano - //diabetiya.ru/pomosh/gestacionnyj-saharnyj-diabet-pri-beremennosti.html

Kuwongolera kwa zamisala

Mu 1933, pamene insulin idayamba kugwiritsidwa ntchito kulikonse, zidadziwika kuti njira yodwala matenda ena am'maganizo idakhala yosavuta wodwalayo atayamba kudwala matendawa. Iwo adabayira mkatikati mobaya jakisoni wambiri, moyang'aniridwa ndi madokotala. Njira ya mankhwala a insulin shock, monga momwe amatchulira, inali yangozi kwa wodwalayo (kufa 2-5%). Kubwera kwa mankhwala a psychotropic, kufunika kwa mankhwala a insulin kwatha, komanso, maphunziro ambiri sanatsimikizire kugwira kwake ntchito. Ku West, mankhwalawa a psychosis omwe ali ndi insulin sikuchitika pano.

Ku Russia, kugwiritsa ntchito mankhwala a insulin kunalinso kochepa kwambiri. Pakadali pano, amaloledwa kugwiritsa ntchito chithandizo chokhacho kwa odwala omwe ali ndi matenda a schizophrenia omwe ali ndi mbiri yochepa yamatenda, omwe sangathe kuthandizidwa ndi njira zina. Njira imakhala ndi mndandanda waukulu wa contraindication ndipo siyogwiritsidwa ntchito konse.

Malangizo a insulin

Kuti mupeze chindapusa chokhazikika cha matenda a shuga mellitus mothandizidwa ndi insulin, muyenera kutsatira malamulo ena:

1. Njira zochizira komanso zotsatira zoyambirira zimaperekedwa ndi adokotala okha.
2. Wodwala ayenera kuphunzitsidwa ndikuthana ndi malamulo owerengera mkate ndi insulin.
3. Asanayambitse insulin, muyenera kuwerengera malangizo a mankhwalawo, kudziwa kuti izi ndizovuta yanji, nthawi yayitali bwanji musanadye jakisoni.
4. Onani ngati syringe ili yoyenera kwa insulin. Onani kuchuluka kwa singano ndikusintha momwe mungagwiritsire ntchito mankhwalawa mogwirizana ndi izi.
5. Kuyeza shuga pambuyo 2 hours. Pakadali pano, simungathe kulowetsa Mlingo wowonjezera wa mankhwalawa.
6. Ndikofunikira kusunga diary momwe kuchuluka ndi nthawi ya XE, mlingo ndi mtundu wa insulin, ndi zizindikiro za glycemic zikuwonetsedwa.
7. Sinthani malo opaka jakisoni nthawi zonse, osapaka kapena kuwotha.

Kodi zingakhale zovuta ziti

Mavuto ambiri omwe amabwera chifukwa cha kugwiritsa ntchito insulini ndi mankhwala osokoneza bongo ndi hypoglycemia yotsatira. Pazaka zambiri, odwala matenda ashuga 10% amadwala kwambiri shuga kuti azichita bwino kwambiri kapena nthawi yayikulu kwambiri ya hypoglycemia. Awa makamaka ndi odwala omwe samva bwino glucose wotsika kapena ndi neuropathy, zomwe zimapangitsa kuti zikhale zovuta kumva zomwe zikuwonetsa. Amalimbikitsidwa kugwiritsa ntchito mita nthawi zambiri, nthawi zina amawonjezera mipherezero ya shuga ndikuchepetsa mlingo wa insulin.

Hypoflycemia yofatsa imatha kutsimikiziridwa ndi zizindikiro izi:

• nseru
• kunjenjemera miyendo;
• kunjenjemera kapena kumira;
• njala
• ulesi;
• kulephera kulolera.

Sikovuta kusiya kuukira koteroko, ingomwa tiyi wokoma kapena kudya maswiti angapo. Chachikulu ndikumuzindikira pakapita nthawi.

Kuphatikiza pa hypoglycemia, mankhwala a insulin angayambitse: