Anthu omwe ali ndi mtundu woyamba wa shuga amafunikira insulin nthawi zonse. Odwala omwe ali ndi matenda amtundu wachiwiri nthawi zambiri amagwiritsa ntchito mapiritsi apadera kuti achepetse shuga.
Koma nthawi zina mankhwalawo amakhala osakwanira, ndipo muyenera kusinthira pang'ono kapena kusungunulira insulin.
Kusokonezeka kwa endocrine kumakhudza machitidwe onse a thupi. Kuchepetsa chiwopsezo cha zovuta kumatheka chifukwa chokhala ndi shuga mokulira. Kuti muchite izi, ndikofunika kudziwa momwe mungawerengere kuchuluka kwa insulini.
Njira ya odwala matenda ashuga
Pali njira zisanu za insulin mankhwala:
- mankhwala amodzi a nthawi yayitali kapena yapakati;
- njira ziwiri zapakati;
- mahomoni apafupipafupi komanso apakati;
- katatu insulin kukulitsa ndi kuchitapo kanthu;
- maziko a botus.
Poyambirira, jakisoni wothandizirayo amaperekedwa mu tsiku lililonse m'mawa musanadye chakudya cham'mawa.
Chithandizo cha mankhwalawa malinga ndi chiwembuchi sichikubwereza zachilengedwe za kapangidwe ka insulin. Muyenera kudya katatu patsiku: chakudya cham'mawa chochepa, chakudya chamadzulo cham'mawa, chakudya chamadzulo chamadzulo komanso chakudya chamadzulo chochepa. Kapangidwe kake komanso kuchuluka kwa chakudya kumagwirizana ndi kuchuluka kwa zolimbitsa thupi.
Ndi mankhwalawa, hypoglycemia imachitika nthawi zambiri usana ndi usiku. Malowa sanali oyenera kwa odwala matenda ashuga amtundu 1. Odwala omwe ali ndi matenda amtundu wachiwiri ayenera kumwa mapiritsi ochepetsa shuga motsatana ndi jakisoni.
Kuchita insulin kawiri ndi mankhwala apakati kumaphatikizira kumayambiriro kwa mankhwala musanadye chakudya cham'mawa komanso chamadzulo.
Mlingo watsiku ndi tsiku umagawika pawiri pawiri pa 2 mpaka 1. Kuphatikiza apo, chiwembuchi chili pachiwopsezo cha hypoglycemia. Chobwereza ndicho chomwe chimaphatikiza chiwembucho ku boma ndi zakudya.
Wodwala ayenera kudya osachepera 4-5. Kubayidwa kawiri kwa mahomoni apakatikati komanso achidule pancreatic amadziwika kuti ndiabwino kwambiri kwa ana ndi akulu. Mankhwalawa amaperekedwa m'mawa ndi madzulo.
Mlingo wa tsiku ndi tsiku umatengera kudya, zolimbitsa thupi. Kuchepetsa chiwembucho mu chakudya cholimba: mukapatuka pa dongosolo la mphindi 30, kuchepa kwambiri kwa insulin kumachitika, zizindikiro za hypoglycemia zimawonekera.Makonzedwe atatu a insulin yayitali komanso yochepa imaphatikizira jakisoni m'mawa, masana ndi madzulo.
Asanadye chakudya cham'mawa, wodwalayo amafunika kuti alowetsedwe ndikukonzekera kwakanthawi komanso pang'ono, asanadye nkhomaliro - chakudya chochepa, asanadye - asanakhalepo.
Dongosolo-bolus scheme lili pafupi kwambiri ndi zachilengedwe kupanga insulin. Mlingo wathunthu umagawika m'magawo awiri: theka loyamba ndi lalifupi, ndipo lachiwiri ndi mtundu wanthawi yayitali wa mankhwala.
2/3 ya mahomoni owonjezera amathandizidwa m'mawa ndi masana, 1/3 madzulo. Chifukwa chogwiritsa ntchito Mlingo wocheperako, chiopsezo cha hypoglycemia ndi chocheperako.
Kodi gawo limodzi la insulini limachepetsa bwanji magazi?
Madokotala azindikira kuti gawo la insulini limachepetsa glycemia ndi 2 mmol / L. Mtengo wake umapezeka mosayesa ndipo umaperekedwa.
Mwachitsanzo, mwa odwala matenda ashuga, gawo lamankhwala limatha kuchepetsa shuga ndi mmol / L ochepa. Zambiri zimatengera zaka, kulemera, kadyedwe, ntchito zolimbitsa thupi za wodwala, mankhwala omwe amagwiritsidwa ntchito.
Insulin apidra
Mwachitsanzo, kwa ana, amuna ndi akazi owonda omwe amakhala ndi chidwi chachikulu pakulimbitsa thupi, mankhwalawa amakhala ndi zotsatira zambiri. Mankhwala amasiyana mphamvu: Ultid-yochepa Apidra, NovoRapid ndi Humalog ndi maulendo 1.7 amphamvu kuposa Actrapid wamfupi.
Mtundu wa matenda umakhudzanso. Mwa anthu osadalira insulin, gulu la mahomoni limatha kutsitsa shuga kuposa odwala omwe ali ndi matenda omwe amadalira insulin. Izi ndichifukwa choti mwa anthu omwe ali ndi mtundu wachiwiri wa matenda ashuga, kapamba amatulutsa insulin pang'ono.
Momwe mungawerengere kuchuluka kwa jakisoni wa insulin ya matenda ashuga?
Odwala matenda ashuga asungitse kuchuluka kwa shuga m'dera la 4.6-5.2 mmol / L. Chifukwa chake, muyenera kudziwa mtundu wa insulin yovomerezeka.
Zinthu zotsatirazi zikuthandizira kuwerengera:
- mawonekedwe a matenda;
- Kutalika kwa maphunzirowa;
- kukhalapo kwa zovuta (matenda ashuga polyneuropathy, kulephera kwaimpso);
- kulemera
- kutenga zina zowonjezera kuchepetsa shuga.
Kuwerengera Mlingo wa matenda a shuga 1
Ndi matenda amtunduwu, insulin siyopangika ndi kapamba. Chifukwa chake, pafupifupi tsiku lililonse mlingo umalimbikitsidwa kuti ugawidwe pakati pa mankhwala omwe ali ndi nthawi yayitali (40-50%) ndi yochepa (50-60%).
Kuchuluka kwa insulini kumawerengeredwa potengera kulemera kwa thupi ndikufotokozedwa m'magawo (UNITS). Ngati pali mapaundi owonjezera, ndiye kuti chokwanira chikuchepa, ndipo ngati pali kulemera - onjezerani ndi 0,1.
Chofunikira cha insulin tsiku lililonse chimaperekedwa pansipa:
- kwa omwe apezeka ndi matenda aposachedwa, chizolowezi ndi 0.4-0.5 U / kg;
- kwa iwo omwe akhala akudwala kwa nthawi yoposa chaka chindapusa - 0,6 PIECES / kg;
- kwa anthu omwe ali ndi matenda okhala ndi nthawi yoposa chaka komanso kubwezeretsa kosasunthika - 0,7 PIECES / kg;
- mu mkhalidwe wa ketoacidosis - 0,9 PIECES / kg;
- pa kuwonongeka - 0,8 PIECES / kg.
Kuwerengera kuchuluka kwa matenda ashuga a 2
Mtundu wachiwiri wa odwala matenda ashuga amawonjezera insulin.Mankhwala omwe amangokhala pang'ono amalumikizidwa pomwe kapamba atatha.
Kwa anthu omwe ali ndi vuto la endocrinological lomwe langopezedwa kumene, mulingo woyambirira wa mankhwalawa ndi 0.5 U / kg. Komanso, kukonza kumachitika masiku awiri.
Madokotala amalimbikitsa kuperekera mahomoni pa mlingo wa 0,4 U / kg pachikhululukiro. Ngati munthu wayamba kudwala matenda a shuga kwa nthawi yayitali ndiye kuti mulingo woyenera wamankhwala ndi 0,7 U / kg.
Mlingo wosankha mwana komanso wachinyamata
Kwa ana omwe ali ndi vuto la hyperglycemia kwa nthawi yoyamba, ma endocrinologists amapatsa mayunitsi 0,5 / kg patsiku.
Pankhani ya kuwonongeka ndi kusowa kwa katulutsidwe ka timadzi ndi kapamba, 0,7-0.8 U / kg ndi mankhwala. Ndi chiphuphu chokhazikika, pali kuchepa kwa zofunikira za insulin mpaka 0,4-0,5 U / kg.
Kuwerengera mlingo wa insulin kukonzekera kwa amayi apakati
Kudziwa mlingo woyenera wa mayi wapakati ndikofunika osati kwa mkazi yekha, komanso kwa mwana wake.M'milungu yoyamba 13, ndikulimbikitsidwa kubayitsa 0,6 U / kg, kuyambira 14 mpaka 26 - 0,7 U / kg, kuyambira 27 mpaka 40 - 80 U / kg.
Ambiri a tsiku ndi tsiku mlingo ayenera kuperekedwa pamaso kadzutsa, ndi ena - madzulo.
Ngati kuperekako kwakonzedwa kuti kuchitike pogwiritsa ntchito gawo la cesarean, ndiye kuti jakisoni wa insulin sanachitike patsiku la opareshoni.
Mndandanda wa zitsanzo za jekeseni woyenera wa jakisoni
Kuti mumvetsetse bwino momwe mungawerengere moyenera mulingo wa insulin, tebulo ili m'munsiyi likusonyeza zitsanzo:
| Makhalidwe aumunthu | Mulingo woyenera | |
| 70 kg wamwamuna yemwe ali ndi matenda ashuga 1, wazaka 6.5, woonda, wolipiridwa bwino | Zofunika tsiku lililonse = 0,6 vitengo x 70 kg = 42 mayunitsi | kuchuluka kwa insulin 50% ya 42 mayunitsi = 20 magawo (magawo 12 asanadye kadzutsa ndi 8 usiku) |
| kukonzekera kwapafupi = 22 PIERES (magawo 8-10 m'mawa, 6-8 masana, 6-8 asanadye) | ||
| Amuna 120 kg, alemba 1 shuga m'miyezi 8 | Chofunikira cha tsiku ndi tsiku = 0,6 vitengo x 120 kg = 72 mayunitsi | kuchuluka kwa insulin 50% ya 72 mayunitsi = 36 magawo (20 magawo asanachitike kadzutsa ndi 16 usiku) |
| kukonzekera kwapafupi = PIERESI 36 (magawo 16 m'mawa, 10 pa nkhomaliro, 10 asanadye) | ||
| Mayi 60 kg wopezeka ndi mtundu wachiwiri wa shuga wocheperako chaka chapitacho | Chofunikira cha tsiku ndi tsiku = 0,4 PISCES x 60 kg = 24 ZIWANDA za insulin yotalika (magawo 14 m'mawa ndi 10 madzulo) | |
| Mnyamata wazaka 12, kulemera kwa 37 kg, wadwala posachedwa, chiphuphu chokhazikika | Chofunikira cha tsiku ndi tsiku = 0,4 CHIWERENGERO x 37 makilogalamu = ZINSINSI zakukonzekera (gawo 9 tisanadye chakudya cham'mawa komanso 5 tisanadye) | |
| Amayi oyembekezera, masabata 10, kulemera kwa 61 kg | Chofunikira cha tsiku ndi tsiku = 0.6 x 61 kg = 36 magawo a insulin yowonjezera (magawo 20 m'mawa ndi 16 madzulo) | |
Kodi kudziwa nthawi yayitali bwanji jekeseni asanapange jakisoni?
Zimatenga nthawi yayitali bwanji kuti mupeze insulin kutengera mtundu wa mankhwalawa. Mwachitsanzo, mankhwala othandizira pang'onopang'ono amayamba kutsika shuga pambuyo mphindi 10.
Chifukwa chake, jekeseni iyenera kuchitidwa mphindi 10-12 chakudya chisanachitike. Insulin yochepa imagwiritsidwa ntchito mphindi 45 musanadye.
Zochita za wothandizira nthawi yayitali zimayamba pang'onopang'ono: zimabayidwa ola limodzi asanadye kadzutsa kapena chakudya chamadzulo. Ngati simumayang'anira nthawi yokhazikika, ndiye kuti hypoglycemia ikhoza kuyamba. Kuti muchepetse kuukira, muyenera kudya kena kake lokoma.
Makanema okhudzana nawo
Pazokhudza malamulo a mankhwalawa a matenda a shuga tsiku limodzi komanso tsiku lililonse:
Chifukwa chake, kuti amve bwino komanso kuti muchepetse kukula kwa zovuta za matenda, odwala matenda ashuga ayenera kudziwa momwe angawerengere moyenera kuchuluka kwa insulini yomwe imayendetsedwa.
Kufunika kwa timadzi timeneti kumatengera kulemera, zaka, nthawi komanso kuuma kwa matenda. Akuluakulu amuna ndi akazi sayenera kubayitsa zoposa 1 U / kg patsiku, ndipo ana - 0,4-0.8 U / kg.
