Mitundu ndi ma regimens a insulin

Insulin ndiye mahomoni okhawo omwe amachepetsa shuga m'magazi, amathandizira kuyamwa ndikuchotsa shuga m'matimu, ndikuletsa kupangika kwa matupi a ketone. Omwe amayamba chifukwa cha ketoacidosis, vuto loopsa la matenda ashuga.

Mankhwala a insulin ndi njira yotsogola komanso yogwiritsidwa ntchito kwambiri, yolipirira kulephera kwa kagayidwe kazachilengedwe poyambitsa mankhwala a insulin.

Amagwiritsidwa ntchito pochiza matenda a shuga omwe amadalira insulin, pakanthawi kochepa chithandizo cha matenda ashuga amtundu wa 2, musanachitidwe opareshoni, matenda opatsirana pachimake komanso matenda ena othandizira matenda amtundu wa 2, ngati mankhwala omwe amachepetsa shuga sagwira ntchito. Ganizirani mitundu ndi mfundo za insulin.

Chiwembu

Mankhwala a insulin amachitika malinga ndi chiwembu chapadera chomwe chimapangidwa ndi endocrinologist. Dokotala amasankha mitundu ya insulini (kuchitira mwachangu kapena nthawi yayitali), nthawi ya makonzedwe, mlingo.

Ngati endocrinologist ikupereka chithandizo popanda kufufuza zotsatira za kudziyang'ana pawekha, ndibwino kupeza dokotala wina, apo ayi mutha kupita kwa nephrologist ndi matenda osiyanasiyana a impso kapena madokotala ochita opaleshoni yam'mimba.

Dokotala amayenera kudziwa mtundu wa insulini yomwe ikufunika kuti muchepetse kuchepa kwakanthawi, ngati jakisoni wothamanga amafunikira, kapena ngati wodwala matenda ashuga amafunikira insulin yayitali komanso yayitali.

Dokotala wothandizira endocrinologist amafunika kuyeza glycemia wodwalayo sabata yatha komanso malongosoledwe a zochitika zomwe zikuwazungulira:

1. Nthawi yakudya;
2. Kuchuluka kwake komanso zomwe azidya;
3. Kukhalapo kwa zolimbitsa thupi, kukonza nthawi yake;
4. Kutalika ndi kumwa kwa mankhwala a shuga a mkamwa;
5. Kukhalapo kwa matenda opatsirana ndi zina;
6. Kuchulukitsa kapena kuchepa kwa shuga usiku (zimatsimikiziridwa ngati mlingo wa mahomoni owonjezera umafunika nthawi yogona).

Kuchitika

Chifukwa chiyani jakisoni osati mapiritsi? Pambuyo pakukonzekera pakamwa, chinthucho chimawonongeka mwachangu m'mimba. Kukonzekera kwa insulin kwa anthu, komwe kumagwiritsidwa ntchito pochiritsira, kumapezeka m'njira zingapo: njira yopangira kapena kupanga biosynthetic.

M'mbuyomu, inshuwaransi ya bovine ndi nkhumba idagwiritsidwa ntchito, koma patapita nthawi yayitali zidatsimikiziridwa kuti zomwe zimapezeka m'mabuku awiriwa zimasokoneza thanzi la munthu komanso zimayambitsa zovuta zonse.

Madzi oyeretsa kwambiri tsopano. Zotsatira zomwe zimapangidwa mosiyanasiyana sizikhala ndi zosayipa zoyipa.

Zotsatirazi zimawonjezeredwa ku insulin ya anthu:

• Ndi kutalika kwake zotsatira;
• Tizilombo toyambitsa matenda;
• Kulira.

Musanayambe chithandizo, muyenera kudziwa bwino mfundo ndi malamulo a insulin.

1. Asanalowe, jakisoni wotsekerayo amakonzedwa bwino;
2. Gwiritsani ntchito syringes yapadera ndi singano yopyapyala kapena cholembera.

Ubwino womaliza:

• Singano yopangidwa mwapadera imatha kuchepetsa ululu wa jakisoni;
• Kugwiritsa ntchito mosavuta, jakisoni amatha kuchitika nthawi iliyonse.

Malangizo a mankhwalawa amayenera kukhala:

1. Kusala - jekeseni wa nthawi yayitali komanso yayitali;
2. Kubayira kwakanthawi kochepa musanadye chakudya chamadzulo;
3. "Fast" mahomoni musanadye;
4. Jekeseni wothandizira asanagone.

Zinthu zimakhudza kuchuluka kwa mayamwidwe a insulin:

• Kutentha, kusinthasintha;
• Kodi amawonjezera kuchuluka kwa makonzedwe;
• Zochita zolimbitsa thupi;
• Kodi wodwalayo amakhala ndi nkhawa.

Zisonyezo za mankhwala a insulin:

1. Mtundu woyamba wa shuga
2. Ketoacidosis;
3. Coma;
4. Njira zopatsirana komanso za purapy mu odwala matenda ashuga;
5. Matenda pachimake matenda a matenda ashuga;
6. Kuchita bwino kwa othandizira pakamwa omwe amachepetsa shuga mu mtundu 2 shuga;
7. Wodwalayo adataya kwambiri kulemera kwakanthawi kochepa.

Mitundu ya mankhwala

Ganizirani zamakono zamankhwala a insulin.

Zolimbitsidwa

Njirayi imagwiritsidwa ntchito ngati wodwala alibe kulemera kwambiri, kupanikizika kosalekeza. Mankhwala amapatsidwa gawo lililonse pa kilogalamu ya kulemera kamodzi patsiku. Mokulira amayeserera kubisika kwachilengedwe kwa mahomoni m'thupi.

Migwirizano:

• Hormoni iyenera kuperekedwa mokwanira kuti ichulukitse shuga;
• Zomwe zimayambitsidwa zimayenera kutsata kwathunthu katulutsidwe kam'mimba, komwe kamakhala ndi kapamba amunthu.

Njira imeneyi ndi yoyenera insulin mankhwala a mtundu 1 matenda a shuga.

Zofunikira pamwambapa zimapanga chiwembu cha mtundu wa mankhwala, pomwe Mlingo wa tsiku lililonse wa insulin umagawidwa mu hormone yokhala ndi nthawi yayitali kapena yayitali. Mtundu wotsirizawu umayambitsidwa m'mawa ndi madzulo.

Imwani insulin yocheperako mukatha kudya kwambiri. Chakudya chizikhala ndi chakudya. Dokotalayo amamulembera aliyense payekha.

Wodwala matenda a shuga 1 ayenera kuwayeza glycemia asanadye.

Zachikhalidwe

Iyi ndi njira yophatikiza yomwe imaphatikiza ma insulin a nthawi zingapo zochita jekeseni imodzi. Ubwino waukulu ndikuti kuchuluka kwa jakisoni kumachepetsedwa mpaka katatu patsiku. Izi ndiye kuchuluka kochepa.

Chosangalatsa chachikulu ndikuti samatsata katulutsidwe kamatenda a kapamba mokwanira, chifukwa chake, kulipira kwathunthu kwa kulephera kwa kagayidwe kazakudya kamunthu sikuchitika.

Wodwalayo amapanga jakisoni awiri patsiku, ndikuyambitsa zinthu zazifupi komanso zazitali. Mahomoni okhala ndi nthawi ya magawo awiri mwa magawo atatu a mankhwala. Chachitatu china chimasungidwa ndalama zakanthawi yochepa.

Wodwala wodwala matenda a shuga 1 sangatengepo shuga pafupipafupi asanadye.

Mankhwala a insulin pump

Uwu ndi mtundu wamagetsi omwe amagwiritsa ntchito jakisoni wa insulin yozungulira yozungulira yokhala ndi nthawi yochepa komanso yocheperako nthawi yochepa mumadontho ochepa.

Chipangizocho chimagwira ntchito m'njira zosiyanasiyana:

1. Kupitiliza kwa insulin kopitilira muyeso wa mini (basal rate). Izi zimatsanzira kutulutsidwa kwa mahomoni mumbuyo. Izi zimakupatsani mwayi wogwiritsa ntchito ma insulin omwe akhala akuchita kwa nthawi yayitali.
2. Kuthamanga kwa Bolus - pafupipafupi makonzedwe a mankhwala, odwala matenda ashuga amawongolera payekha palokha. Amagwiritsidwa ntchito musanadye kapena ndi index ya glycemic yowonjezereka.

Mukamagwiritsa ntchito mulingo wa bolus, chithandizo cha insulin chotere chimalocha m'malo mwa mahomoni ndi zochita zazifupi kapena zazifupi. Kuphatikizika kwa mitundu kumapereka chilinganizo chapafupi kwambiri cha katulutsidwe ka mahomoni. The catheter amalowa m'malo masiku atatu aliwonse.

Hormoni imalowa kudzera mu zotupa za pampu. Cannula yapadera imayikidwa pansi pa khungu pomwe singano ya syringe imayikidwa ndi maluso ena. Amapatsidwa Mlingo wochepetsetsa mwachangu kwambiri ndipo wodwalayo amapatsidwa mankhwala nthawi yomweyo. Magawo amatha kusintha mphindi 30 zilizonse.

Ubwino wina wogwiritsa ntchito chipangizocho:

• Mlingo wokwanira, kuchuluka kochepa kwa mlingo wa bolus;
• Chiwerengero cha ma punctuff chachepa;
• Zimathandizira kuwerengetsa mulingo wa insulin (wodwalayo amalowetsa chidziwitso pa miyeso yake ya glycemic ndi zizindikiro zina mu pulogalamuyi);
• Chipangizocho chimatha kukonzedwa kuti chisagwiritse ntchito mlingo wa bolus nthawi yomweyo, koma chimachulukitsa njirayi (chothandiza ngati wodwala matenda ashuga azidya pang'ono pang'onopang'ono kapena paphwando lalitali);
• Pompo mosalekeza imayeza glycemia, kuchenjeza ndi shuga wambiri;
• Kukhazikitsidwa kwa chinthu kuphatikiza shuga kumatha kusintha liwiro (mwachitsanzo, kuperekera kwa mahomoni kumazimitsidwa ndi hypoglycemia);
• Mapampu amakono amatha kusunga chipika cha data kwa miyezi ingapo, kufalitsa chidziwitso pakompyuta, ntchito yake ndi yabwino kwambiri kwa wodwala ndi dokotala.

Chithandizo cha mitundu yosiyanasiyana ya matenda ashuga

Njira zochizira matenda a shuga 1 amadziwika ndi insulin kawiri pa tsiku. Kukhazikitsidwa kwa bolus - musanayambe kudya.

Kuphatikiza kwa maboma kumatchedwa chithandizo choyambira cha bolus, komanso regimen yambirimbiri. Chimodzi mwazomwe zimachitika ndi insulin.

Endocrinologist amasankha mlingo, poganizira zinthu zambiri. Insulin ya basal imatha kukhala pafupifupi 50% ya tsiku ndi tsiku. Mlingo wa mahomoni am'mimba umawerengeredwa payekhapayekha.

Mankhwala a shuga a mtundu wa 2 amayamba ndi kuwonjezereka kwapang'onopang'ono kwa michere yaying'ono ya mapuloteni omwe amapezeka m'magazi omwe amachepetsa shuga. Ngati wodwalayo adayamba kutumiza mankhwala a basal oyambira, 10 IU tsiku lililonse mlingo amasankhidwa. Muyenera kupereka mankhwalawo nthawi yomweyo.

Chithandizo choyambirira

Monga gawo la njira zochiritsira ana, mahomoni "apafupi" ndi "apakati" amaphatikizidwa. Mwanjira yosavuta, kubwezeretsa zabwino kuyenera kusungidwa. Ngati mwana ali ndi zaka zopitilira 12, pamachitika mankhwala amphamvu.

Mlingo umasinthidwa m'magawo. Zotsatira zimatsimikizika masiku angapo. Kusintha kwa mlingo m'mawa ndi madzulo sikuyenera kuloledwa. Posankha njira yothandizira, dokotala amaganizira zinthu zingapo komanso mawonekedwe a thupi la wodwala pang'ono.

Mitundu yapamwamba ya mankhwalawa imathetsa chiopsezo chazakudya zosafunikira komanso kukula kwa lipodystrophy pamalo a jekeseni. Ndi lipodystrophy, palibe mafuta. Uku ndikovuta kwambiri. Matendawa amathandizidwa nthawi yayitali, ndipo simungathe kusiya jakisoni.

Anthu odwala matenda ashuga aubwana omwe ali ndi chidwi chachikulu amatenthedwa ndi analogenes yovomerezeka. Ndi njira iyi, chiwopsezo cha kuchepa kwambiri kwa glucose ndizochepa kwambiri chifukwa cha mlingo woyenera wa mankhwala.

Kuyang'anira mkhalidwe wa ana m'zaka zoyambirira za moyo ayenera kukhala osamala kwambiri, popeza momwe ntchito yogwiritsira ntchito mankhwala odalirika komanso yosadalirika imakhala yosadalirika.

Chithandizo cha amayi apakati

Mankhwala apakati a insulin amakhala ndi shuga wokwanira osatha kudya ndikatha kudya. Kagayidwe ka mkazi osakhazikika, kukonza pafupipafupi zamankhwala ndikofunikira. Kufunika kwa insulin panthawiyi kumawonjezeka.

Popewa hyperglycemia, jakisoni 2 patsiku nthawi zambiri amaperekedwa m'mawa komanso chakudya. Zakudya zazifupi, zapakatikati, zophatikizika zimagwiritsidwa ntchito chakudya choyamba komanso chomaliza.

Amalepheretsa kugona kwa hyperglycemia usiku ndi jakisoni wopangidwa asanagone. Hypoflycemia yofatsa ndiyotheka. Kwa amayi omwe ali ndiudindo, izi sizowopsa. Ngati mukuwopseza kuti musanabadwe musanabadwe, njira yovomerezeka ya magnesium sulfate imayikidwa. Mankhwala ena ochepetsa shuga kwa mayi wapakati amalekanitsidwa.

Pa nthawi yobereka, glycemia imayang'aniridwa mosamala komanso nthawi. Itha kudumpha chifukwa cha kupsinjika kapena kugwa kwambiri.

Kwa matenda amisala

Kuchiza nthawi zambiri kumatanthauza odwala a schizophrenia. Kupenda koyambirira kwa mkhalidwe wa odwala kumachitika. Ndi chithandizo cha insulini mu zamisala, jakisoni woyamba amachitika pamimba yopanda kanthu, kumapeto kwa sabata - yopuma.

Hypoglycemia imayamba. Odwala amatha kudandaula za kufooka, njala, ludzu, kufinya, kutuluka ndikotheka. Zomwe zimachitika ndizathamanga. Odwala akamachita ulesi amamva zomwe zikuchitika, amagona.

Munthawi imeneyi, amayimirira kwa maola atatu. Amapereka kapu ya tiyi wokoma otentha, chakudya cham'mawa chambiri. Mlingo wa glycemia umabwezeretsedwa, odwala amabwerera kwawo komwe anali.

Pa gawo lotsatira la mankhwalawa, kuchuluka kwa mankhwalawa kumawonjezereka, chikumbumtima chodwala chimayamba kugundika. Vutolo limasinthidwa pakatha mphindi 20, dontho limayikidwa. Njira yothira shuga imathiridwa, kenako ndikudya bwino kwambiri.

Pomaliza, chithandizo chamankhwala chimamuthandiza wodwalayo kukhala m'malire a mzere wofanana ndi chikomokere. Pakatha theka la ola, wodwalayo amayamba "kubwerera" mwachangu.

Gwiritsani ntchito magawo awiri. Mlingo wa mahomoni umachepetsedwa pang'onopang'ono mpaka utatha.

Ndi chithandizo cha insulin chotere m'maganizo, zotsatirazi zingachitike:

1. Chotetemera chikomokere. Wodwalayo sangabwezeredwe momwe anali kale. Ndiye yankho la tiyi wa khofi, glucose amalowetsedwa mu mtsempha. Ngati palibe zotsatira, yankho la adrenaline limagwiritsidwa ntchito. Simungabayikenso shuga kenaka motsatizana. Mpweya wochokera ku hypoglycemic amatha kukhala hyperglycemic.
2. Abwereza chikomokere. Kutha kukhala kanthawi mutayimitsa chikondwerero choyamba. Vutolo limayima chimodzimodzi ndi momwe limakhalira wamba.

Zotsatira zoyipa zosayenera

Mavuto a insulin:

• Chiwopsezo cha kupha majekisiti. Madera ofiiridwenso ndi kuwuma kumawonekera pambuyo paukadaulo wosayenera wa jakisoni, kugwiritsa ntchito singano zonenepa kwambiri, insulin, kusankha malo osayenera.
• Lipodystrophy, momwe gawo lopukusira lamafuta limasowa pamalo a jakisoni. Fossa yaying'ono.
• Lipohypertrophy. Zisindikizo zamafuta zimawonekera malo a jekeseni.

Vuto linanso ndilakuti kuchuluka kwa shuga kumachepa, hypoclycemia imayamba. Odwala amamva njala yayikulu, thukuta limachuluka, kugwedezeka kumawonekera, kugunda kwa mtima kumafulumizitsa. Zimachitika chifukwa chobweretsa mlingo waukulu kapena chakudya chochepa. Mankhwala, kuchita masewera olimbitsa thupi mochulukirapo kungakhudze kukula kwa zinthu.

Ndiwopepuka komanso lolemera. Amachotsa okha hypoglycemia paokha, amatenga michere. Amadutsa mwachangu komanso popanda kutsatira. Fomu yayikulu ikhoza kutsagana ndi hypoglycemic chikomokere. Wodwala amafunikira chithandizo chamankhwala chodzidzimutsa.

Kulemba mankhwala molakwika kumawonjezera vuto la wodwalayo. Kulephera kwamkati kumatha kuchitika, kuthiridwa kwa magazi ku miyendo kumatha kusokonezeka. Kenako zigawenga zimatha kutha.

Cholinga chachikulu cha chithandizo chamakono cha insulini ndikusunga kuchuluka kwa kagayidwe kazinthu kamphamvu pafupi ndi kamene kamawonedwa mwa munthu wathanzi. Shuga wokwezeka nthawi zonse amabweretsa zovuta zazikulu: matenda a shuga, ketonuria, ketoacidosis, kulemala, kudula miyendo, kufa msanga kwa odwala.