Sichingakhale kukokomeza kunena kuti pobwera insulin analogues nthawi yatsopano idayamba m'miyoyo ya odwala matenda ashuga. Chifukwa cha kapangidwe kake kapadera, amalola kuti glycemia iwongoleredwe kuposa kale. Insulin Levemir ndi m'modzi mwa oimira mankhwala amakono, analogue ya basal hormone. Zawoneka posachedwa: ku Europe mu 2004, ku Russia patatha zaka ziwiri.
Levemir ili ndi mawonekedwe onse a insulin yayitali yayitali: imagwira chimodzimodzi, popanda kupindika kwa maola 24, imayambitsa kuchepa kwa usiku hypoglycemia, sikuti imapangitsa kuti odwala azichita bwino, zomwe zimakhala zowona makamaka kwa matenda ashuga a 2. Zotsatira zake ndizodziwikiratu komanso zimadalira mtundu wa munthu kuposa NPH-insulin, ndiye kuti mankhwalawa ndikosavuta kusankha. M'mawu ochepa, ndikofunikira kuyang'anitsitsa mankhwalawa.
Malangizo achidule
Levemir ndiye kholo la kampani ya ku Danish ya Novo Nordisk, yomwe imadziwika ndi mankhwala othandizira odwala matenda ashuga. Mankhwalawa adadutsa maphunziro ambiri, kuphatikiza ana ndi achinyamata, pa nthawi yomwe ali ndi pakati. Onsewa sanatsimikize chitetezo cha Levemir okha, komanso kuchita bwino kwambiri kuposa ma insulins omwe amagwiritsidwa ntchito kale. Kuwongolera shuga kumatheka bwino mofananamo matenda ashuga amtundu 1 komanso m'malo okhala ndi vuto lochepa la mahomoni: mtundu 2 kumayambiriro kwa insulin mankhwala ndi matenda a shuga.
Zambiri zazokhudza mankhwalawa kuchokera kuzomwe mungagwiritse ntchito:
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%
| Kufotokozera | Njira yopanda utoto yodzaza ndi U100, yoyikidwa mu makatoni am'magalasi (Levemir Penfill) kapena ma cholembera a syringe omwe safuna kufatsa (Levemir Flexpen). |
| Kupanga | Dzina ladziko lonse losagwirizana ndi chophatikizika cha Levemir (INN) ndi insulin. Kuphatikiza apo, mankhwalawa ali ndi zokometsera. Zida zonse zimayesedwa poizoni ndi carcinogenicity. |
| Mankhwala | Limakupatsani mwayi wofanizira kumasulira kwa basal insulin. Amakhala ndi kusiyanasiyana kochepa, ndiye kuti, zotsatira zake zimasiyana pang'ono osati mwa wodwala m'modzi wokha yemwe ali ndi matenda a shuga masiku osiyanasiyana, komanso odwala ena. Kugwiritsa ntchito insulin Levemir kumachepetsa kwambiri chiopsezo cha hypoglycemia, zimawonjezera kuzindikira kwawo. Mankhwalawa pakali pano ndi insulin "yolemetsa-yosalowerera", imakhudza thupi, imathandizira kuoneka kuti ndi yodzala. |
| Zomwe zimayamwa | Levemir imapanga ma insulin ovuta kuphatikizira - hexamers, yomwe imamangiriza mapuloteni pamalo opangira jakisoni, kotero kuti kumasulidwa kwake kwa minofu yapansipansi imakhala yochepa komanso yofanana. Mankhwalawa alibe mawonekedwe apamwamba a Protafan ndi Humulin NPH. Malinga ndi wopanga, zomwe Levemir akuchita zimakhala zosalala kuposa zomwe akupikisana naye kuchokera ku gulu limodzi la insulin - Lantus. Pakugwiritsa ntchito nthawi, Levemir idutsa kokha mankhwala amakono kwambiri a Tresiba, opangidwa ndi Novo Nordisk. |
| Zizindikiro | Mitundu yonse ya matenda ashuga omwe amafunikira insulini kuti apatsidwe malipiro abwino. Levemir amachita chimodzimodzi kwa ana, achinyamata ndi achikulire odwala, angagwiritsidwe ntchito kuphwanya chiwindi ndi impso. Ndi mtundu wa 2 shuga, kugwiritsa ntchito kwake molumikizana ndi othandizira a hypoglycemic ndikololedwa. |
| Contraindication | Levemir sayenera kugwiritsidwa ntchito:
Mankhwalawa amaperekedwa pokhapokha, kutsekeka kwapakati sikuletsedwa. Kafukufuku wa ana osakwana zaka ziwiri sanachitepo, chifukwa chake gulu ili la odwala limanenedwanso mu contraindication. Komabe, insulin iyi imalembera ana aang'ono kwambiri. |
| Malangizo apadera | Kuthetsa kwa Levemir kapena kutumikiridwa mobwerezabwereza kwa mlingo wosakwanira kumabweretsa kwambiri hyperglycemia ndi ketoacidosis. Izi ndizowopsa makamaka ndi matenda amtundu 1 shuga. Kuchuluka kwa mlingo, kulumpha chakudya, katundu osagwiritsidwa ntchito kumadzaza ndi hypoglycemia. Ngati kunyalanyaza mankhwala a insulini komanso kusinthana kwapafupipafupi kwa glucose wambiri komanso wotsika, zovuta za shuga zimayamba mofulumira kwambiri. Kufunika kwa Levemire kumawonjezeka panthawi yamasewera, panthawi ya matenda, makamaka ndi kutentha kwambiri, panthawi yoyembekezera, kuyambira theka lake lachiwiri. Kusintha kwa Mlingo wofunikira kumapangitsa kuti pakhale kutupa kwapachuma komanso kufalikira kwa matenda osachiritsika. |
| Mlingo | Malangizowo akuwonetsa kuti kwa matenda amtundu 1 wa shuga, kuwerengetsa kwa munthu aliyense kwa wodwala aliyense. Ndi matenda amtundu wa 2, kusankha kwa mankhwalawa kumayamba ndi magawo 10 a Levemir patsiku kapena mayunitsi a 0-0-0.2 pa kilogalamu, ngati kulemera kwake kumasiyananso kwakukulu. Mwakuchita izi, kuchuluka kumeneku kungakhale kochulukirapo ngati wodwala amatsata zakudya zama carb ochepa kapena ngati akuchita nawo masewera olimbitsa thupi. Chifukwa chake, ndikofunikira kuwerengera nthawi ya insulin yayitali malinga ndi ma algorithms apadera, poganizira glycemia m'masiku ochepa. |
| Kusunga | Levemir, monga ma insulin ena, amafunika kutetezedwa pakuwala, kuzizira ndi kutentha kwambiri. Kukonzekera kovunda sikungasiyane mwanjira iliyonse ndi yatsopano, chifukwa chake chisamaliro chapadera chiyenera kulipidwa pazosungidwa. Makatsegulo otseguka amakhala kwa milungu isanu ndi umodzi pa kutentha kwa firiji. Mabotolo a spare amasungidwa mufiriji, moyo wawo wa alumali kuyambira tsiku lopanga ndi miyezi 30. |
| Mtengo | Makatoni 5 a 3 ml (mayunitsi okwana 1500) a Levemir Penfill mtengo kuchokera ku ma ruble 2800. Mtengo wa Levemir Flexpen ndiwokwera pang'ono. |
Zambiri pazogwiritsa ntchito Levemir
Levemir ali ndi mfundo yogwirira ntchito, kuwonetsa komanso kuwonetsa zofanana ndi ma insulin ena. Kusiyanitsa kwakukulu ndi kutalika kwa chochita, mlingo, ndondomeko yovomerezeka ya magulu osiyanasiyana a odwala omwe ali ndi matenda ashuga.
Kodi insulin levemir ikuyenda bwanji?
Levemir ndi insulin yayitali. Zotsatira zake ndizotalikirapo kuposa zamankhwala osokoneza bongo - chisakanizo cha insulin ya anthu ndi protamine. Pa mlingo wa mayunitsi 0,3. pa kilogalamu, mankhwalawa amagwira ntchito maola 24. Mlingo wochepera, wocheperako nthawi yogwira ntchito. Odwala omwe ali ndi matenda a shuga, kutsatira zakudya zamafuta ochepa, izi zitha kutha patatha maola 14.
Insulin yayitali silingagwiritsidwe ntchito kukonza glycemia masana kapena pogona. Ngati shuga ochulukirapo akupezeka madzulo, ndikofunikira kupanga jakisoni waifupi wa insulin, ndipo pambuyo pake, tengani timadzi tambiri tomwe timatulutsa. Simungasakanikize ma insulin analogi amtundu umodzi mu syringe yomweyo.
Kutulutsa Mafomu
Insulin Levemir motsatira
Levemir Flexpen ndi Penfill amasiyana mawonekedwe okha, mankhwalawo ali ofanana. Penfill - awa ndi makatiriji omwe amatha kuyikidwa mu ma cholembera kapena kutumizira insulin kuchokera kwa iwo ndi syringe yovomerezeka. Levemir Flexpen ndi cholembera chodzaza chomwe chimagwiritsidwa ntchito mpaka yankho litakwaniritsidwa. Sangadzazitsidwe. Ma cell amakulolani kuti mulowetse insulin muzowonjezera za 1 unit. Afunika kugula payokha NovoFayn singano. Kutengera ndi kukula kwa tinthu tating'onoting'ono, makamaka tating'ono (0.25 mm)) 6 mm kutalika kapena kupyapyala (0.3 mm) 8 mm amasankhidwa. Mtengo wa paketi ya singano 100 ndi pafupifupi ma ruble 700.
Levemir Flexpen ndi yoyenera kwa odwala omwe ali ndi moyo wokangalika ndi kusowa kwa nthawi. Ngati kufunika kwa insulini kuli kochepa, gawo limodzi la 1 sikulola kuti muimbire molondola mlingo womwe mukufuna. Kwa anthu otere, Levemir Penfill amalimbikitsidwa kuphatikiza cholembera cholondola kwambiri, mwachitsanzo, NovoPen Echo.
Mlingo woyenera
Mlingo wa Levemir amaonedwa kuti ndi wolondola ngati sikuti amasala kudya kokha, komanso hemoglobin wa glycated ali paliponse. Ngati chiphuphu cha shuga sichikwanira, mutha kusintha insulin yayitali masiku atatu aliwonse. Kuti mudziwe kukonza koyenera, wopangayo amalimbikitsa kutenga shuga wambiri pamimba yopanda kanthu, masiku atatu omaliza akukhudzidwa pakuwerengera
| Glycemia, mmol / l | Kusintha kwa Mlingo | Mtengo wowongolera, mayunitsi |
| < 3,1 | Kuchepa | 4 |
| 3,1-4 | 2 | |
| 4,1-6,5 | Palibe kusintha | 0 |
| 6,6-8 | Kuchulukitsa | 2 |
| 8,1-9 | 4 | |
| 9,1-10 | 6 | |
| > 10 | 10 |
Nkhani yofananira: Malamulo owerengera kuchuluka kwa insulin ya jakisoni
Ndondomeko ya jekeseni
- Ndi matenda a shuga 1 Malangizo akutsimikizira kukonzekera kwa insulin kawiri: mutadzuka ndi asanagone. Dongosolo lotere limapereka chindapusa kwabwino kwa odwala matenda ashuga kuposa amodzi. Mlingo amawerengedwa mosiyana. Kwa insulin yam'mawa - yozikidwa pa shuga tsiku ndi tsiku osala kudya, chifukwa chamadzulo - kutengera ndi zomwe zimachitika usiku.
- Ndi matenda a shuga a 2 onse osakwatira ndi awiri makonzedwe ndizotheka. Kafukufuku akuwonetsa kuti kumayambiriro kwa mankhwala a insulin, jakisoni imodzi patsiku ndikokwanira kukwaniritsa kuchuluka kwa shuga. Mankhwala okhazikika limodzi safuna kuti munthu awonjezere kuchuluka kwake. Popeza munthu amakhala ndi matenda a shuga kwa nthawi yayitali, insulin yayitali imakhala yolondola kuperekera kawiri patsiku.
Gwiritsani ntchito ana
Pofuna kuloleza kugwiritsa ntchito Levemir m'magulu osiyanasiyana a anthu, maphunziro akulu okhudzana ndi odzipereka amafunikira. Kwa ana ochepera zaka ziwiri, izi zimalumikizidwa ndi zovuta zambiri, chifukwa chake, mu malangizo ogwiritsira ntchito, pali malire. Zofananazo zilipo ndi ma insulini ena amakono. Ngakhale izi, Levemir imagwiritsidwa ntchito bwino mu makanda mpaka chaka. Kuthandizirana nawo kumakhala kopambana monga mwa ana okulirapo. Malinga ndi makolo, palibe zoyipa zilizonse.
Kusintha ku Levemir ndi NPH insulin ndikofunikira ngati:
- shuga yosala kudya sakhazikika,
- hypoglycemia imawonedwa usiku kapena nthawi yamadzulo,
- mwana wonenepa kwambiri.
Kuyerekeza kwa Levemir ndi NPH-insulin
Mosiyana ndi Levemir, onse a insulin omwe ali ndi protamine (Protafan, Humulin NPH ndi ma analogi awo) ali ndi kutchulidwa kwakukulu, komwe kumawonjezera chiopsezo cha hypoglycemia, kudumpha kwa shuga kumachitika tsiku lonse.
Ubwino Wotsimikiziridwa ndi Levemir:
- Ili ndi kuthekera kowonekeratu.
- Amachepetsa mwayi wa hypoglycemia: kwambiri ndi 69%, usiku ndi 46%.
- Zimapangitsa kuti muchepetse kulemera kochepa ndi matenda a shuga a 2: m'masabata a 26, kulemera kwa odwala ku Levemir kumawonjezera ndi kilogalamu 1.2, komanso odwala matenda ashuga a NPH-insulin ndi 2.8 kg.
- Imayendetsa kumverera kwa njala, zomwe zimabweretsa kuchepa kwa chilala kwa odwala omwe ali ndi kunenepa kwambiri. Anthu odwala matenda ashuga ku Levemir amathera pafupifupi kcal 160 / tsiku zochepa.
- Kuchulukitsa katulutsidwe ka GLP-1. Ndi matenda amtundu wa 2, izi zimapangitsa kuti awonjezeke insulin yawo.
- Imakhala ndi phindu pa kagayidwe kamchere wamchere, komwe kumachepetsa chiopsezo cha matenda oopsa.
Drawback yokhayo ya Levemir poyerekeza ndi kukonzekera kwa NPH ndi mtengo wake wokwera. Zaka zaposachedwa, zalembedwera m'ndandanda wa mankhwala ofunikira, chifukwa chake odwala omwe ali ndi matenda ashuga amatha kupeza kwaulere.
Analogi
Levemir ndi insulin yatsopano kwambiri, motero ilibe mafuta okwera mtengo. Malo omwe ali pafupi kwambiri komanso nthawi yayitali ndi mankhwala osokoneza bongo omwe ali m'gulu la insulin analogues - Lantus ndi Tujeo. Kusunthira ku insulin ina kumafunanso kuti mupeze kuchuluka kwa mankhwalawa ndipo mosakayikitsa kumabweretsa kuwonongeka kwakanthawi pobwezeretsa matenda a shuga, chifukwa chake, mankhwalawa ayenera kusinthidwa pazifukwa zachipatala, mwachitsanzo, ndi tsankho la munthu payekha.
Levemir kapena Lantus - zomwe zili bwino
Wopanga adavumbulutsa zabwino za Levemir poyerekeza ndi mpikisano wake wamkulu - Lantus, yemwe adawonetsa mosangalala malangizo:
- zochita za insulin ndizosatha;
- mankhwalawa amapatsa mphamvu zochepa.
Malinga ndi ndemanga, kusiyana kumeneku ndi kosavomerezeka, choncho odwala amakonda mankhwala, mankhwala omwe ndi osavuta kupeza m'derali.
Kusiyanitsa kofunikira komwe ndikofunikira kwa odwala omwe amachepetsa insulin: Levemir imasakanikirana bwino ndi saline, ndipo Lantus amataya zinthu zake pang'ono atasungunuka.
Mimba ndi Levemir
Levemir sikukhudza chitukuko cha fetalChifukwa chake, angagwiritsidwe ntchito ndi amayi apakati, kuphatikizapo omwe ali ndi matenda ashuga. Mlingo wa mankhwalawa pakakhala pakati pamafunika kusinthidwa pafupipafupi, ndipo ayenera kusankhidwa limodzi ndi adokotala.
Ndi matenda amtundu woyamba 1, odwala panthawi yomwe akubala mwana amakhalabe pa insulin yomweyo yomwe adalandira kale, ndiye kusintha kwake. Kusintha kuchokera ku mankhwala a NPH kupita ku Levemir kapena Lantus sikofunikira ngati shuga ali wabwinobwino.
Ndi matenda a shuga a gestational, nthawi zina zimakhala zotheka kukwaniritsa glycemia popanda insulin, pokhapokha pakudya komanso masewera olimbitsa thupi. Ngati shuga amakwezedwa pafupipafupi, mankhwala a insulin amafunikira kuti muchepetse matenda a fetus mu fetus ndi ketoacidosis mwa amayi.
Ndemanga
Ndemanga za odwala ambiri za Levemir ndi zabwino. Kuphatikiza pakupititsa patsogolo kayendedwe ka glycemic, odwala amawona kugwiritsa ntchito mosavuta, kulolera bwino, mabotolo abwino ndi zolembera, singano zowonda zomwe zimakupatsani mwayi kuti mupange jakisoni osapweteka. Ambiri odwala matenda ashuga amati hypoglycemia pa insulin iyi imakhala yocheperako komanso yofooka.
Ndemanga zoyipa ndizosowa. Amachokera makamaka kwa makolo a makanda omwe ali ndi matenda ashuga komanso azimayi omwe ali ndi matenda ashuga. Odwala awa amafunika Mlingo wa insulini wochepetsedwa, motero Levemir Flexpen sakukhala bwino kwa iwo. Ngati sipangakhale njira ina iliyonse, ndipo ndi mankhwala okhawo omwe angapezeke, odwala matenda ashuga amayenera kuchoka mu cholembera chinyere ndikuchiyanjananso china kapena kupanga jakisoni ndi syringe.
Zochita za Levemir ndizodabwitsa kwambiri amayamba masabata 6 atatha kutsegulidwa. Odwala omwe amafunikira insulin yayitali alibe nthawi yocheza ndi magawo 300 a mankhwalawa, ndiye kuti zotsalazo ziyenera kutayidwa.
