Soluble waumunthu wopanga insulin ndi zonse za izo

Udindo wa insulini m'thupi ndi osatheka kuzikulitsa. Mulingo uliwonse wa kusowa kwa insulini umakhala wambiri ndi matenda oopsa a endocrine - matenda ashuga. Zaka 40 zapitazo, odwala matenda ashuga sanakhalepo zaka zopitilira 10-15.

Mankhwala amakono amagwiritsa ntchito insulin yofunikira kwambiri yaumunthu yopanga ma genulin kuti isinthe magazi. Chifukwa cha mankhwalawa, matenda ashuga asiya kukhala chiganizo, kupatsa mwayi odwala kwa moyo wonse komanso wautali.

Chifukwa chiyani insulin imatchedwa "genetically engineer"

Odwala ena amachita mantha ndi mawu oti "opangidwa mwabadwa," kuwakumbutsa "GMOs oyipa."

M'malo mwake, kunali kupangidwa kwa mankhwalawa komwe kunapulumutsa miyoyo ya anthu mamiliyoni ambiri odwala matenda a shuga.

Poyamba, madokotala amagwiritsa ntchito insulin yotalikirana ndi nyama (makamaka nkhumba ndi ng'ombe). Komabe, mahomoni awa sanali achilendo kwa anthu okha, komanso adalowa m'magazi, ndikupangitsa kudumpha mu glucose ndikupangitsa zovuta zambiri.

Insulin yoyambira inapangidwa ndikuganizira zofunikira zonse za wodwala yemwe ali ndi matenda ashuga, ndikupangitsa mitundu yosiyanasiyana yokhudza thupi. Pambuyo poti ichitike, imagwera ma amino acid wamba ndipo imatuluka m'thupi.

Chachikulu mankhwala

Mafuta a insulle a insulin amatanthauza mankhwala osokoneza bongo omwe amakhala osakhalitsa.

Pamodzi ndi cell wall receptor, mankhwalawa amapanga insulin receptor zovuta zomwe zimapangitsa njira zina:

1. Kupatulidwa kwa michere yathunthu kukonzanso ndi kukhathamiritsa kwa glucose ndi minofu;
2. Kuchulukitsidwa kwa intracellular transport ndi glucose;
3. Kuchuluka kwa mapangidwe a glycogen mu chiwindi;
4. Kuthandizira kupanga mapuloteni ndi mafuta.

Ndi subcutaneous makonzedwe, mankhwalawa amayamba kugwira ntchito pambuyo pa mphindi 20-30, ndikufika pazokwanira mkati mwa maola 1-3, pafupifupi maola 5-8.

Mankhwalawa amagawidwa mosiyanasiyana m'matumbidwe: mwachitsanzo, samalowa mkati mwa chotchinga komanso samadutsa mkaka wa m'mawere. Mapeto ake atatha, insulin ya munthu imachotsedwa kudzera mu impso (pafupifupi 80%) itawonongedwa ndi insulinase.

Zizindikiro zogwiritsidwa ntchito

Nthawi zambiri, madokotala amatipatsa insulin yosungunuka milandu:

• Kudzichitira nokha kapena kuphatikiza mankhwala a mtundu 1 ndi mtundu 2 matenda a shuga;
• Kukana kwathunthu kapena pang'ono (kukana) kwa thupi kumankhwala opatsirana pakamwa (otengedwa pakamwa) antidiabetesic;
• Matenda a shuga panthawi yokhala ndi pakati (ngati zakudya sizikuyenda bwino);
• Mavuto a shuga mellitus (ketoacidosis, hypersmolar kapena ketoacidotic chikomokere);
• Njira ya matenda a shuga motsutsana maziko angapo matenda;
• Zowopsa m'malo mwa anthu odwala matenda ashuga omwe ali pamlomo wothira mankhwala ochepetsa shuga (nthawi yothandizila, matenda akulu, kuvulala kapena frostbite, musanabadwe, ndi zina zambiri);
• Matenda ashuga nephropathy kapena chiwindi kuwonongeka;
• Zotupa za khungu la Dystrophic (furunculosis, carbuncles, zilonda);
• Kusinthira ku insulin ndi mphamvu yayitali (yayitali).

Contraindication

Contraindicated ogwiritsira ntchito insulin mu:

• Kutsitsa shuga wamagazi (hypoglycemia);
• Kuchulukitsa chidwi chathupi lathunthu ku insulin.

Zotsatira zoyipa

Ngakhale idalekerera bwino, insulin ikhoza kukhala ndi zotsatirapo zoyipa ngati:

1. Kukula kwa hypoglycemia chifukwa chokana mankhwala ndi thupi kapena immunological zochita zake ndi insulin;
2. Thupi lawo siligwirizana (urticaria, kuyabwa kapena kwambiri Quincke edema ndi kutupa lakuthwa nkhope ndi mucous nembanemba, pallor ndi kufupika kwa mpweya);
3. Hypoglycemic chikomokere;
4. Kusokonezeka kwa chikumbumtima (nthawi zina mpaka kukomoka);
5. Hyperglycemia kapena diabetesic acidosis (motsutsana ndi maziko akumatenda kapena matenda, chakudya chosakwanira, atabayidwa jakisoni kapena mlingo wolakwika);
6. Kuzindikira kwamtundu wabwino mu mawonekedwe a ludzu, kugona, kuchepa kwa chakudya, redness ya nkhope;
7. Zomwe zimachitika mderalo poyambira limodzi (kuwotcha, kuyabwa, redness, kuchuluka kapena kuwonetsa kwa minofu ya adipose).

Kuphatikiza ndi mankhwala ena

Mukamagwiritsa ntchito insulin yaumunthu ndi mankhwala ena, mphamvu yake ya hypoglycemic imalimbitsidwa kapena kufooka.

Kuchepetsa shuga kumatha kuchitika pakumwa insulin ndi:

1. Sulfonamides (sulfonamide kapena othandizira a hypoglycemic);
2. Mao inhibitors (furazolidone, etc.);
3. ACE inhibitors (Captopril, enalapril, etc.);
4. NSAIDs inhibitors (aspirin, diclofenac, etc.);
5. Androgens ndi anabolic steroids (Anavar, Androxon, etc.);
6. Mankhwala a Antimalarial (quinoline, quinidine, etc.);
7. Tetracyclines (tetracycline, doxycycline);
8. Mankhwala ena (theophylline, pyridoxine, morphine, ndi ena otero)

Kuti muchepetse kuthamanga kwa mankhwalawa, kugwiritsa ntchito kwake ndi:

• Glucocorticoids;
• Amphetamines;
• Estrogens (kuphatikiza njira yolerera pakamwa);
• Zowonjezera;
• Sympathomimetics;
• Mahomoni a chithokomiro;
• Mankhwala olekanitsidwa (triamterone, phenytoin, glucagon).

Komanso, kuphatikizapo insulin, mankhwalawa amatha kuchepetsa kapena kupititsa patsogolo zotsatira za hypoglycemic:

1. Beta-blockers;
2. Reserpine;
3. Morphine;
4. Octreotide.

Ntchito ndi kusankha kwa mankhwalawa

Mlingo ndi njira yoyendetsera insulin ya anthu nthawi zonse imatsimikiziridwa payekhapayekha ndi endocrinologist, mukuganizira zofunikira za shuga ndi mkodzo wa wodwalayo.

Mankhwalawa amaperekedwa m'magulu a shuga m'njira zingapo: subcutaneously (s / c), intramuscularly (i / m) kapena kudzera m'mitsempha (i / v). Nthawi zambiri, insulin imayendetsedwa kamodzi. Kuti muchite izi, gwiritsani ntchito:

• Mimba;
• Mapewa;
• Khungu limakulunga kumtunda.

Mankhwala nthawi zambiri kutumikiridwa m`nsinga mu pachimake zinthu chifukwa cha matenda ashuga: ketoacidosis, matenda ashuga.

Amalangizidwa kuti apereke insulin 15-30 mphindi musanadye, katatu patsiku. Nthawi zina 5-6 imodzi ya mankhwalawa amaloledwa.

Mlingo wa insulin nthawi zambiri amawerengedwa mogwirizana ndi magawo a 0,5-1 pa 1 makilogalamu. Ngati insulin imaperekedwa zoposa 0,6 mg wa pa kilogalamu ya thupi, ndiye kuti mankhwalawa amayenera kuperekedwa kawiri pa tsiku. Pafupifupi, tsiku lililonse mlingo pafupifupi 30-40 (mwa ana, magawo 8).

Amayi oyembekezera nthawi zambiri amapatsidwa muyeso wa mayunitsi 0,6 pa kilogalamu iliyonse. Jekeseni nthawi zambiri amatulutsa katatu pa tsiku, malinga ndi kuchuluka kwa zakudya.

Nthawi zambiri, insulin yothamanga imaphatikizidwa ndi insulin yokhala nthawi yayitali.

Malamulo a insulin

Ngakhale akatswiri odziwa bwino za matenda ashuga amalakwitsa popereka insulin.

Malamulo ofunikira kwambiri a insulin Therapy ndi awa:

1. Kuyang'ana moyo wa alumali ndi malo osungira mankhwalawa: sayenera kuwonetsedwa ndi kutenthedwa kapena hypothermia.
2. Refreshate insulin mbale Mbale. Ndikokwanira kusunga botolo loyambira m'malo amdima firiji.
3. Kuyanjananso kwa mankhwalawa ndi malangizo ndi upangiri wa dokotala.
4. Tulutsani mpweya ku syringe musanalowe. Sikoyenera kupukuta khungu ndi mowa. Kulimbana ndi matenda a insulin ndikosowa kwambiri, ndipo mowa umachepetsa mphamvu ya mankhwalawo.
5. Kusankha malo oyenera kukhazikitsa. Kwa insulin yochepa, uwu ndi m'mimba. Ikabayidwa m'khosi komanso pang'onopang'ono, mankhwalawa amagwira ntchito pang'onopang'ono.
6. Kupewa kwa zovuta pamalo a jekeseni momwe mungagwiritsire ntchito dera lonse lapansi. Poyambitsa insulini yokhala ndi kanthawi kochepa, pamimba ponsepo mumagwiritsidwa ntchito: kuchokera pamwamba pakepa mpaka kumapeto, ndikugundika kwa patoko. Ndikofunika kubwezeretsanso pafupifupi 2 cm kuchokera pamalo akale a jekeseni, ndikuyambitsa syringe pakona madigiri 45-60, kuti mankhwalawa asatayike.
7. Musanagwiritse ntchito mankhwalawa, ndibwino kuti mutenge khungu lanu ndi chala ndi chala chamanthu. Ngati ilowa m'matumbo, mankhwalawa amachepetsa ntchito yake. Mukayika singano, gwiritsani syringe kwa masekondi 5-10.
8. M'mimba, insulin yochepa imayendetsedwa bwino mphindi 20 asanadye. M'malo ena, mankhwalawa amaperekedwa theka la ola musanadye.

Zina zamalonda zamankhwala

Insulin imapangidwa ngati njira yothetsera jakisoni ndipo imagulitsidwa ku malo ogulitsa mankhwala.

Mtundu wa insulin wopangidwa ndi anthu umatha kupangidwa pansi pa mayina amtunduwu:

• Biosulin;
• Actrapid;
• Actrapid NM;
• Gensulin;
• Tidzazitsogolera;
• Chifwamba.

Chifukwa cha matekinoloje amakono a chibadwa, insulin (recombinant) ya insulin ya anthu inapangidwa. Ndi iye omwe ali m'gulu la zomwe akukonzekera: Humodar, Humulin, Insuman, Gansulin, Humalog, Apidra SoloStar, Mikstard. Mankhwalawa amasiyana ndi oyamba mu kusintha kwa ma amino acid, omwe amawonjezeranso zinthu zina zatsopano (mwachitsanzo, zotsatira zazitali za magawo awiri), zomwe ndizofunikira kwambiri kwa odwala matenda ashuga.

Zotsatira zoyipa

Ngakhale alekerera bwino, mankhwalawa amatha kukhala ndi zotsatirapo zina:

• Zokhudza immunological ndi wodwalayo insulin;
• Thupi lawo siligwirizana (urticaria, kuyabwa) kapena edema ya Quincke (ndi kufinya kwa nkhope ndi mucous nembanemba, pallor,
• Kupuma kovuta, khungu lamtambo, kapena kusokonezeka kwa chikumbumtima);
• Hypoglycemic chikomokere;
• Kusokonezeka kwa chikumbumtima (nthawi zina kumakomoka);
• Hyperglycemia kapena diabetesic acidosis (motsutsana ndi maziko akumatenda kapena matenda, chakudya chosakwanira, atabayidwa jakisoni kapena mlingo wolakwika);
• Wanjala, kugona, kuchepa kwa chakudya, kufupika kwa nkhope;
• Kuwonetsera kwachidziwitso poyambira limodzi (kuwotcha, kuyabwa, kuchulukitsa kapena atrophy ya adipose minofu).

Nthawi zina kumayambiriro kwa kumwa mankhwalawa kumakhala mawonekedwe awonekedwe amisokoneza osiyanasiyana owoneka (kuwona kawiri, kusakanizika, ndi zina) kapena mawonekedwe a edema. Koma zimasintha thupi ndikudwala pakatha milungu ingapo.

Bongo

Zimachitika kuti utsogoleli wa insulin nthawi zina umabweretsa hyperglycemia.

Zizindikiro zazikulu za hyperglycemia ndizowonetsera:

• Zofooka;
• Pallor;
• Thukuta lakuzizira;
• Zotsatira
• Mutu;
• Kumverera kwanjala;
• Mitsempha;
• Kuchuluka kwa lilime, milomo, miyendo.

Zizindikiro zofananazi zikayamba, wodwalayo ayenera kudya chakudya chamagulu ochepa (nthawi zambiri maswiti, shuga kapena tiyi).

Mavuto

Kuchiza kwa nthawi yayitali ndi insulin kumatha kubweretsa zovuta zingapo. Mitu ikuluikulu ndi:

1. Kupezeka kwa hypoglycemia. Izi zitha kuthandizidwa ndi mavuto azakudya, mankhwala osokoneza bongo, masewera olimbitsa thupi, matenda a impso ndi chiwindi.
2. Postinjection lipodystrophy. Kupewa kwa matenda ndikusintha malo a jakisoni, kuwonjezera njira ya novocaine (0.5-1,5 ml) ku insulini, ndikuyika syringe mu Ѕ ya makulidwe a minofu ya adipose.
3. Kukana kwa mankhwala. Mankhwala ena (omwe nthawi zambiri amaphatikizidwa) omwe amachepetsa shuga amasankhidwa.
4. Thupi lawo siligwirizana. Kugwiritsa ntchito mankhwala othandizira (antihistamines, glucocorticoids) ndi kusintha kwina kwa mankhwalawa.

Insulin yamtundu wa anthu ndiyomwe imapulumutsa kwa odwala ambiri a shuga. Komabe, ndikofunikira kugwiritsa ntchito mankhwalawa mwanzeru, poganizira malamulo onse a kayendetsedwe kake. Ndikofunikira kuti dokotala akuwongolereni mankhwalawa, kuwerengetsa mlingo wake ndikuwunika momwe wodwalayo alili panthawi yonse ya chithandizo.