Mitundu iti ya insulin ndi nthawi yake yochita

Kupanga kwa insulini m'thupi lathu kumasintha. Kuti mahomoni alowe m'magazi kuti atsanzire kutulutsa kwake komwe, odwala matenda ashuga amafunika mitundu yosiyanasiyana ya insulin. Mankhwalawa omwe amatha kukhala m'misempha yayitali kwa nthawi yayitali ndipo amalowerera m'magazi amagwiritsidwa ntchito kupangitsa matenda a glycemia kukhala pakati pa chakudya. Ma insulin omwe amafika mofulumira m'magazi amafunika kuti muchepetse shuga m'matumbo pazakudya.

Ngati mitundu ndi Mlingo wa mahomoni amasankhidwa molondola, glycemia mu odwala matenda ashuga komanso anthu athanzi amasiyana pang'ono. Poterepa, akuti shuga imalipidwa. Kubwezera matendawa ndi cholinga chachikulu cha mankhwalawo.

Kodi insulin imagawidwa bwanji?

Insulin yoyamba idapezeka kuchokera ku nyama, kuyambira pamenepo yakhala ikusinthidwa koposa kamodzi. Tsopano mankhwala osokoneza bongo a nyama sagwiritsidwanso ntchito, adasinthidwa ndi ma genetic engineering hormone ndi ma insulin analogies atsopano. Mitundu yonse ya insulini yomwe tili nayo ingagawidwe m'magulu a mamolekyulu, nthawi yayitali komanso momwe amapangira.

Njira yothetsera jakisoni itha kukhala ndi mahomoni a mitundu yosiyanasiyana:

1. Wamunthu. Adalandira dzina ili chifukwa amabwereza kwathunthu kapangidwe ka insulin m'matumbo athu. Ngakhale ma molekyuli adachitika mokwanira, kutalika kwa insulin yamtunduwu ndi kosiyana ndi kwamoyo. Hormone yochokera ku kapamba imalowa m'magazi nthawi yomweyo, pomwe mahomoni ochita kupanga amatenga nthawi kuti atenge kuchokera kuzinthu zowononga.
2. Insulin analogues. Thupi lomwe limagwiritsidwa ntchito limapangidwa ngati insulin yaumunthu, ntchito yofanana ndi yochepetsera shuga. Nthawi yomweyo, zotsalira za amino acid zochepa zomwe zimakhala mu molekyulu zimasinthidwa ndi wina. Kusintha kumeneku kumakupatsani mwayi kufulumizitsa kapena kuchepetsa liwiro la mahomoni kuti mubwereze mwatsatanetsatane kapangidwe ka thupi.

Mitundu yonse iwiri ya insulini imapangidwa ndi mainjiniine. Homoni imatheka chifukwa chokakamiza kuti isakanikize tizilombo ta Escherichia coli kapena yisiti, pambuyo pake mankhwalawa amatsukidwa kambiri.

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%

Popeza nthawi ya insulin ikhoza kugawidwa m'magulu awa:

Kutengera ndi kapangidwe kake, mankhwalawo amagawidwa kukhala amodzi ndi amodzi. Zoyambazo zimakhala ndi insulini yamtundu umodzi wokha, zotsalazo zimaphatikizira zazifupi komanso zapakatikati kapena ma ultrashort ndi mahomoni akutali mosiyanasiyana.

Ultrashort insulin

Kubwera kwa insulin ya ultrashort inali gawo lofunikira kwambiri pakubwezeretsa chiphuphu cha matenda ashuga. Mbiri yamachitidwe mwa iwo ili pafupi kwambiri ndi ntchito ya mahomoni achilengedwe. Kafukufuku awonetsa kuti kugwiritsa ntchito insulin yamtunduwu kumatha kuchepetsa shuga kwa odwala omwe ali ndi matenda ashuga, kuchepetsa chiopsezo cha hypoglycemia ndi zovuta zina.

Mitundu ya insulin ya inshiortort imalembedwa kuti iwoneke pamsika:

Mapindu omwe atchulidwa patebulopo sakhala othandiza kwa odwala matenda ashuga ambiri, chifukwa chake mutha kusankha mankhwalawa chifukwa cha insulin. Kusinthanitsa ndi insulin imodzi ndi inzake ndikofunikira pokhapokha ngati pali tsankho pamagawo a mankhwalawa, omwe ndi osowa kwambiri.

Insulin yochepa

Mtunduwu umaphatikizapo ma insulin aumunthu oyera, apo ayi amatchedwa okhazikika. Zomwe zikuchitika pakukonzekera kwapfupi sizigwirizana kwenikweni ndi thupi. Kuti akhale ndi nthawi yowonjezera ntchito yawo, amafunika kupindika theka la ora asanadye. Pamafunika chakudya chochuluka pang'onopang'ono m'zakudya. Pansi pa izi, kutuluka kwa glucose m'magazi kumagwirizana ndi nsonga ya insulin yochepa.

Nthawi yonse ya mankhwalawa amtundu wa mankhwalawa imafika maola 8, zotsatira zake zazikulu zimatha pambuyo pa maola 5, motero insulin imakhalabe m'magazi pamene glucose yazakudya idatha kale. Popewa hypoglycemia, odwala matenda ashuga amakakamizidwa kuti azikhala ndi zokhwasula-khwasula.

>> Tinakambirana za insulin yayifupi mwatsatanetsatane apa - //diabetiya.ru/lechimsya/insulin/insulin-korotkogo-dejstviya.html

Ngakhale zolakwitsa, ma insulin afupipafupi nthawi zambiri amalembera odwala matenda ashuga. Kudzipereka kwa madokotala kumachitika chifukwa chodziwa zambiri ndi mankhwalawa, mtengo wawo wotsika, komanso kugwiritsa ntchito kwina kulikonse.

Mitundu ya insulin yochepa:

Onsewa ali ndi mahomoni amunthu ngati chinthu chogwira ntchito, ali ndi mbiri yapafupi pochita, ndipo amalipiritsa monga momwe ziliri ndi shuga.

Ma Medi-akuchita insulin

Glucose amalowa m'magazi osati kuchokera pakudya, komanso kuchokera ku chiwindi, komwe amakhala ngati glycogen. Kutulutsidwa kwa chiwindi kuli pafupifupi nthawi zonse, kumakhala ndi insulini yaying'ono m'magazi kuti iwonongeke. Kuonetsetsa kuti mulingo wambiri wa mahomoniwa, mankhwala ogwirira ntchito apakatikati amagwiritsidwa ntchito.

Monga ma insulin afupiafupi, apakatikati samatchulanso chinsinsi cha thupi. Amakhala ndi nsonga, pambuyo pake kutsika kwa shuga pang'onopang'ono kumachepa. Hypoglycemia ndiyotheka pachimake; michere yowonjezera ingafunike. Kutalika kwa zochita kumadalira mlingo womwe umaperekedwa, kotero odwala matenda ashuga omwe ali ndi kuchepa kwa mphamvu ya mahomoni amatha kukumana ndi hyperglycemia nthawi zonse.

Mitundu ya insulin yochita pakati:

Mankhwala omwe ali pamwambawa, kuphatikiza ndi insulin ya anthu, ali ndi protamine sulfate. Izi zimachepetsa kuyamwa kwa mahomoni kuchokera pamalo a jakisoni. Mankhwala okhala ndi zowonjezera zoterezi amatchedwa isophan, kapena NPH-insulin. Mosiyana ndi mitundu ina, kukonzekera komwe kumagwira ntchito nthawi zonse kumakhala kwamtambo: mitundu yosanja yomwe ili pansi pa botolo, komanso chamadzimadzi chomveka bwino pamwamba. Asanayambe makonzedwe, amafunika kusakanikirana. Kulondola kwa mlingo womwe waperekedwa, ndipo, motero, momwe mankhwalawo amathandizira, zimatengera kutsimikizika kwa kuyimitsidwa.

Kuchita insulin nthawi yayitali

Mankhwalawa, monga apakatikati, ndizofunikira, ndiye kuti, amasunga shuga wamba kunja kwa chakudya. Mitundu yayitali kapena yayitali ya insulin imasiyana ndi avareji pokhapokha, imapereka zambiri zodziwikiratu, kutalika kwa nthawi kumatengera mlingo ndi malo a jakisoni. Ngati musankha mulingo woyenera, hypoglycemia panthawi yochita kwambiri sizichitika. Pambuyo pachilumbachi, kukonzekera kumapitilizabe kugwira ntchito mogwirizana kwa tsiku limodzi kapena kupitirira.

>> Nkhani yapadera yokhudza insulin yowonjezera - //diabetiya.ru/lechimsya/insulin/dlinnyj-insulin.html

Mitundu ya insulin yayitali:

Kugwiritsa ntchito maanulopus amakono kwambiri m'matenda a shuga kumawonjezera chitetezo ndi chithandiziro, kumalipira chindapusa chokhazikika komanso chokhazikika cha matendawa.

Mitundu ya insulini imangokoka - mtengo wokwera. Anthu odwala matenda ashuga ku Russia amatha kupeza mankhwalawa kwaulere ngati endocrinologist amawona kuti ndioyenera kugwiritsa ntchito. Chitetezo cha patent cha insulin analogi chimatha, chifukwa posachedwa titha kuyembekezera kuwoneka kwa mitundu yambiri yotsika mtengo yogulitsa. Mwachitsanzo, kampani yakunyumba Geropharm imakonzekera kupanga Ultra-yochepera lispro ndi aspart, glargine yayitali ndi degludec.

Mayankho amafunso ndi malingaliro

Pansipa amafunsidwa pafupipafupi za insulin ndi mayankho ake.

Momwe mungamvetsetse kuti ndi insulin iti yomwe ili yoyenera kwa inu

Ndi matenda amtundu wa 1 shuga, mitundu yotsatirayi ya insulini imafunikira kuti insulini ichite bwino:

• wamfupi kapena wowonjezera wafupi
• wapakatikati kapena wautali.

Matenda a shuga amtunduwu amachititsa kuti inshuwaransi itheretu, popanda jakisoni wa mahomoni, ketoacidosis imayamba mwachangu, kenako kukomoka kumayamba. Kuti mubwereze bwino bwino momwe mankhwala a insulin amathandizira, mankhwalawa amalimbikitsidwa: timadzi tambiri tambiri timayendetsedwa 1-2 patsiku, yochepa musanadye chakudya chilichonse, poganizira zomwe zimapezeka m'matumbo. Mabungwe onse apadziko lonse a endocrinologists amakonda ma insulin analogi (awiri a ultrashort - mankhwala yayitali). Amathandizira kuchepetsa kuchepa kwa glycated hemoglobin, chiopsezo chochepa cha hypoglycemia.

Ndi mtundu 2 wa shuga, zonse ndizovuta. Insulin nthawi zambiri imalembedwa kwa odwala pamene mwayi wa mapiritsi ochepetsa shuga utatha. Monga lamulo, pofika nthawi ino, odwala matenda ashuga amakhala ndi hyperglycemia, mavuto atayamba. Pakadali pano, odwala amalimbikitsidwa kuti ayambitse mankhwala a insulin posachedwa kwambiri pamene hemoglobin ya glycated itaposa gawo la chandamale (7.5%).

Pa gawo loyamba, insulin ya basal imatha kutumikiridwa musanayambe kugona kapena kukonzekera magawo awiri musanadye mpaka katatu pa tsiku. Kusankhidwa kwa mankhwala ena ake ndikadali kofunikira kukambirana m'mabungwe azachipatala, koma malinga ndi zotsatira za maphunziro ambiri, insulin ya biphasic ikadali yabwino.

Njira iyi ya mankhwala a insulin ikasiya kupereka chindapusa chokwanira cha matenda a shuga, amasinthidwa kukhala owonjezera, ofanana ndi omwe amagwiritsidwa ntchito ngati matenda amtundu 1.

Zosakaniza zopanga insulin - zomwe akatswiri amaganiza

Kukonzekera magawo awiri (kuphatikiza, kusakanikirana) ndi zosakanikirana zaumunthu kapena ma analog insulins a kutalika kosiyanasiyana kachitidwe. Pangani mankhwala omwe ali ndi kuchuluka kwakutalika kwa mahomoni ofupikira / aatali: kuchokera 25/75 mpaka 50/50.

Zophatikiza ndi ma insulini a anthu

• Germany Insuman Comb 25;
• Swiss Humulin M3;
• Russian Gensulin M30, Biosulin 30/70, Rosinsulin M 30/70.

Zosakaniza za insulin:

• Swiss Humalog Remix 25, 50;
• Danish NovoMix 30.

Malingaliro a Katswiri

Arkady Alexandrovich

Endocrinologist wodziwa zambiri

Funsani katswiri funso

Mphamvu ya biphasic insulin yaumunthu ili pafupi ndi basal insulin analogues. Ma bumpasic insulin analog ali apamwamba pakugwira bwino ntchito pamagulu onsewa. Kafukufuku akuwonetsa kuti ndi matenda amtundu wa 2 shuga, kuwonjezera Humaloga Remix kapena NovoMix ku metformin kumapereka zotsatira zabwino: m'miyezi 6, hemoglobin ya glycated imatsika kukhala yofanana mwa odwala 100%.

Kugwiritsa ntchito insulin yayitali popanda kuwononga pang'ono

Mukakhala ndi matenda amtundu wachiwiri wa shuga, metformin imodzi imakhala yosakwanira, imodzi mwamafuta amodzi amawonjezeredwa ku regimen. Izi zimaphatikizapo zotumphukira za sulfonylurea, DPP-4 inhibitors, analogi za GLP-1 ndi basal insulin. Horm yayitali mumtengo yaying'ono imalilidwa madzulo. Pa nthawi yomweyo, osati kusintha kwachilengedwe kwa zizindikiro za shuga kumawonedwa, komanso kusintha kwa kapangidwe ka insulin masana. Izi ndichifukwa choti jab ya insulin yowonjezera imachepetsa zovuta zomwe zimapangitsa kuti shuga asungidwe pama cell a beta, omwe amatulutsa timadzi timeneti.

Ndi matenda a shuga 1 amtundu, insulin yayitali popanda yochepa imatha kugwiritsidwa ntchito mwachidule kwambiri - munthawi ya "kukondana ndi uchi". Uku ndikusintha kwakanthawi kantchito ya maselo a beta mu matenda osokoneza bongo omwe amayamba chifukwa cha kuyamba kwa insulin. Phwando laukwati limatha mwezi umodzi mpaka miyezi isanu ndi umodzi. Pambuyo pake, odwala nthawi yomweyo amasintha kupita ku insulin.