Mankhwala a insulin - kukhazikitsidwa kwa mankhwala a mahomoni ofotokoza insulin kwa wodwala ndi cholinga cholowererapo. Chithandizo choterechi chimaperekedwa kwa pafupifupi odwala onse amtundu 1 komanso mawonekedwe a matenda a shuga, odwala ena omwe ali ndi matenda amtundu wa 2. Mankhwalawa amaperekedwa pokhapokha ngati jekeseni.
Katswiri wodziwa bwino amasankha mtundu wa insulin mankhwala, amawerengera ndi kusankha mankhwala ofunikira. Pambuyo pake, wodwala matenda ashuga amaphunzira kuwerengera yekha insulin. Izi ndizofunikira kuti tisinthe kuchuluka kwa mahomoni omwe abwera nthawi yakusintha kwa moyo, pomwe kufunika kwake kumawonjezeka kapena kuchepa. Kuti mumve zambiri za momwe mungawerengere insulini kuti mupeze matenda a shuga, onani nkhaniyo.
Kodi cholinga ndi mankhwala a insulin ndi ndani?
The pancreatic timadzi insulin zotchulidwa motere:
- mawonekedwe a shuga a insulin;
- kuwonongeka boma la insulin-payokha mawonekedwe a "matenda okoma";
- kusowa kwa chithandiziro ndi mankhwala ena;
- kuchepa kwakukulu kwa kulemera kwa odwala motsutsana ndi matenda a shuga;
- nthawi ya bere ndi kubadwa kwa mwana;
- kuwonongeka kwa impso za matenda ashuga;
- lactic acidosis;
- hyperosmolar chikomokere;
- matenda ashuga ketoacidosis.
Kuwoneka kwa fungo la mkamwa kuchokera mkamwa ndi chizindikiro cha matenda oopsa a shuga, momwe makonzedwe a insulin amafunikira
Cholinga cha mankhwala a insulini ndicho kubwereza kwambiri momwe mungathere zokhudza insulin mwa munthu wodwala. Kuti muchite izi, gwiritsani ntchito mitundu yonse ya mankhwala a mahomoni.
Mitundu ya kukonzekera kwa insulin
Kukonzekera konse kutengera ndi maholide amakondedwewa amagawidwa m'magulu angapo, zomwe zimafotokozedwera patebulopo.
Mtundu wa mankhwala | Mayina amalonda | Zoyambira | Nthawi yayitali | Kutalika kwa chochita |
Kukonzekera kwa Ultrashort | Humalog, Apidra | 5-10 mphindi | 60-90 mphindi | Mpaka maola 5 |
Zida Zachidule | Rosinsulin R, Humulin Wokhazikika, Gensulin R | 15-30 mphindi | 90-150 mphindi | Mpaka maola 6 |
Mankhwala | Rinsulin N, Biosulin N, Protafan NM | 90-120 mphindi | Pambuyo pa maola 7-9 | Kufikira maola 15-16 |
Mankhwala okhalitsa | Lantus, Levemir | 90-120 mphindi | Ofooka | 1-1,5 masiku |
Mitundu
Ntchito yopanga mahomoni ndi kapamba ikupitilira ola limodzi. Kuchuluka kwa magawo 30 mpaka 60 a zinthu zomwe zimapangidwa patsiku, zomwe zimagwiritsidwa ntchito pochotsa shuga m'magazi kupita kuzinthu zama cell ndi minofu, zomwe zimapangitsa kuti glycemia ikhale yachilendo. Pali mitundu iwiri ya mahomoni opanga:
- mtundu woyambira wa kaphatikizidwe - thunthu limapangidwa mu Mlingo wocheperako tsiku lonse (mpaka magulu a 2 pa ola limodzi);
- Peak mtundu wa kaphatikizidwe - timadzi timene timatulutsa timadzi tambiri pambuyo poti chakudya chamafuta amayamba kugonjetsedwa mthupi, ndikumawonjezera shuga wamagazi (mpaka 2 PIERESES ya 12 g iliyonse ya saccharides).
Kusankha dongosolo la insulin, endocrinologist imaganizira kuchuluka kwa shuga m'magazi, kukhalapo kwa zovuta zamatenda oyamba, jenda ndi zaka za wodwalayo, kulemera kwake kwa thupi. Malamulo a chithandizo cha mahomoni amafuna kusankha mitundu yoyenera yamankhwala m'chipatala chilichonse.
Makina owonera
Katswiriyu amapanga ma insulin angapo pokonzekera zochitika zosiyanasiyana. Izi zitha kuchitika motere. Kawiri patsiku, ma insulin "apakati" amaperekedwa kwa wodwala, ndipo asanadye chilichonse, njira yothetsera ultrashort imabayidwa. Izi zimakupatsani mwayi wothandizira kuchuluka kwa mahomoni m'thupi.
Zofunika! Njira imagwiritsidwa ntchito pochiza matenda a shuga a insulin-odziimira okha komanso odwala matenda a insulin.
Chofunikira pakufunika kwa njira yodutsira pacakumwa ndi kuphunzitsa wodwalayo kuwerengetsa kuchuluka kwa ma jakisoni pakuchita zolimbitsa thupi, kusintha kadyedwe, panthawi ya kupuma kwamatenda oyamba ndi zina. Zoyipa za njirayi ndizofunikira pakuwunika tsiku ndi tsiku shuga wamagazi ndi chiopsezo chachikulu chokhala ndi boma la hypoglycemic.
Glucometer - chipangizo chosakira chomwe mungafotokozere za shuga m'magazi
Makonda
Amawerengera okalamba odwala matenda ashuga omwe ali ndi mawonekedwe odziyimira pawokha (mtundu 2) wamatendawa. M'mawa pamimba yopanda kanthu, amapaka jekeseni "wopanda", ndipo amakonda kukhala ndi insulin yayitali asanagone. Njira yachikhalidwe ya mankhwala a insulin imatanthawuza kuti chakudyacho chimakhala ndi kuchuluka kwa chakudya tsiku lililonse, kotero mlingo wa mayankho a mankhwalawa ndi chimodzimodzi.
Kuwerengeredwa kwa mlingo wa mankhwala "wamfupi"
Kuti mumvetsetse zomwe ndizofunikira posankha mankhwalawa, muyenera kumvetsetsa tanthauzo la "mkate". Kugwiritsa ntchito mawuwo kumathandizira kuti munthu amene alibe maphunziro azachipatala asamavutike. Mkate umodzi wama mkate umaganiziridwa kuti ndi wofanana ndi 12 g ya Saccharides.
Pofuna kusokoneza gawo ili mthupi la munthu, kuchuluka kwa insulini kumafunika. Ilibe manambala pafupipafupi, amasinthasintha tsiku lonse:
- m'mawa 1 XE imafuna 2 PIECES ya mahomoni;
- masana, 1 XE imafuna 1 U ya chinthu chogwira ntchito molimbitsa thupi;
- madzulo, 1 XE imafunikira insulin ya 1.5 U.
Kuti mulingo woyenera wa insulin ukhale wolondola, mawerengeredwe ayenera kupangidwa, koma choyamba muyenera kukumbukira malamulo ofunikira:
- Muyenera kuyang'anira manambala a zopatsa mphamvu tsiku ndi tsiku. Amawerengeredwa ndi katswiri, poganizira za jenda, malamulo a thupi, kulemera kwa odwala, kuchuluka kwa zochita zake zolimbitsa thupi. Nthawi zambiri, kwa munthu wokhala ndi kulemera kwa 65 kg, zopatsa mphamvu za calorie sizidutsa 1800 kcal.
- Kuchulukitsa kwa ma sacarides omwe amabwera ndi chakudya masana nthawi zambiri kumakhala 55-60%.
- Gramu ya saccharide imatulutsa mphamvu ya 4 kcal.
- Mukamawerengera kuchuluka kwa mankhwala a mahomoni, kuchuluka kwa mapuloteni ndi ma lipids omwe amalandiridwa muzakudya za tsiku ndi tsiku sizikumbukiridwa.
- Choyamba, amawerengetsa kuti ndi "lalifupi" liti ndipo kenako ndi insulin yayitali.
Ndikofunika kuti odwala matenda ashuga asungireko buku lawung'ono lomwe mutha kusungitsa zinthu zonse panthawi ya makonzedwe ake
Ndikofunikira kuganizira za thupi la wodwala. Zotsatirazi zikuwonetsa kuchuluka kwa magawo a yankho lalifupi omwe amafunikira pa kilogalamu imodzi ya kulemera panthawi ya matenda ashuga:
- nthawi ya zizindikiro zazikulu - 0,5;
- "kulingalira bwino" - 0,4;
- zinachitikira zamatenda a zaka 3-10 - 0,8;
- kuwonongeka kwa "matenda okoma" - 1-1.5;
- nthawi yomwe kugonana asanayambe - 0,7;
- kutha msinkhu - mpaka 2.
Tiona chitsanzo cha kuwerengera kwamilandu yamankhwala. Mwachitsanzo, pali wodwala yemwe amalemera makilogalamu 65, akudwala kwa zaka zitatu. Zochita zake zolimbitsa thupi zili pamlingo wapakati. Zinthu za calorie za tsiku ndi tsiku za munthu wotero ndi 1080 kcal (60% ya 1800 kcal pazinthu zonse). Ngati tilingalira kuti kugawanitsa gramu ya Saccharide kumatulutsa mphamvu ya 4 kcal, 1080 kcal = 270 g pazogulitsa zomwe zimakhala ndi mafuta ochulukirapo.
Zinanenedwapo kale kuti gawo la mkate ndilofanana ndi 12 g ya Saccharides, zomwe zikutanthauza kuti 270 g = 22 XE. Nutritionists anena mobwerezabwereza kuti pakudya m'mawa muyenera kuphimba 30% ya mtengo wamagetsi (7 XE), masana - 40% (8 XE), madzulo - 30% (7 XE). Zotsatira zake kuti odwala matenda ashuga amafunikira kuchuluka kwa mankhwala "afupikitsidwe" kuti atengere syringe:
- musanadye kadzutsa - magawo 7 a mkate x 2 magawo a insulin = 14 magawo;
- musanadye nkhomaliro - magawo 8 a mkate x 1 UNITS yothetsera = 8 UNITS;
- musanadye chakudya chamadzulo - magawo 7 a mkate x 1.5 ZINSINSI za mahomoni = 10 ZIWANDA zamankhwala.
Chigoba cha mkate chimakhala ngati 50 kcal
Kuwerengeredwa kwa Hormone Wokhalitsa
Ngati insulini yapakatikati imagwiritsidwa ntchito, imaperekedwa kawiri pa tsiku, jakisoni wamankhwala atamwa nthawi yayitali amachitika kamodzi asanagone. Poyamba, muyenera kuwerengetsa kuchuluka kwa zinthu zomwe zimagwira tsiku lililonse kwa wodwala wina.
Kulemera kwake kwa thupi kumachulukitsidwa ndi chimodzi mwazomwe zikuwonetsera kuchuluka kwa UNIT pa kilogalamu ya kulemera (tafotokozazi, wosankhidwa kutengera nyengo ya matendawa). Manambala 3 amachotsedwa pamtengo omwe wapezeka (m'mawa, masana, mlingo wa madzulo wa insulin yayifupi). Zotsatira zake zidzakhala kuchuluka kwa mahomoni a ED osakhalitsa omwe ayenera kulowetsedwa.
Katswiri wodziwa bwino yemwe amaphunzira ndi algorithm popereka insulin kwa odwala, amasankha njira yabwino kuti mankhwalawo alowe mthupi (kugwiritsa ntchito insulin, cholembera kapena pampu), ndikuphunzitsa momwe angayendetsere glycemia kunyumba.
Mimba insulin mankhwala
Kukhazikitsa kwa mahomoni munthawi ya bere ndi njira yofunika kwambiri yochizira matenda amiseche komanso mtundu wina uliwonse wa matenda ashuga. Insulin imawonedwa ngati yotetezeka kwa amayi ndi mwana, imatha kuletsa kukula kwa zovuta nthawi yapakati komanso pobereka.
Ziwerengero zotsatirazi za glycemic kwa mkazi ziyenera kukwaniritsidwa:
- musanadye kadzutsa - osapitirira 5.7 mmol / l;
- mutatha kudya - osapitirira 7.3 mmol / l.
Kuyeza kwa shuga tsiku lililonse m'magazi kumakupatsani mwayi wotsimikizira kapena kutsimikizira momwe mankhwalawo amathandizira. Pambuyo kuwerengera tsiku ndi tsiku mankhwala, 2/3 imayikidwa musanadye chakudya cham'mawa, ena onse - chakudya chamadzulo chisanachitike.
Kugwiritsa ntchito timadzi tambiri pochiritsa matenda amanjenje
Mbali ya schizophrenia mankhwala ndi yotere:
- musanadye kadzutsa, magawo 4 a mahomoni amayendetsedwa (Lolemba);
- tsiku lililonse mlingo umachulukitsidwa ndi 1 PIECES (Lachisanu zizindikirazo zili kale PISITSI 8;
- osatipatsa mankhwala omwe amapezeka kumapeto kwa sabata.
Ili ndi gawo loyamba la chithandizo. Wodwala amabweretsedwa mkhalidwe wa hypoglycemia momwe iye amakhala kwa maola angapo, ndiye kuti zizindikirazo zimabwezeretsedwa ndi chakudya chamagulu omwera ndi chakumwa chokoma kwambiri.
Gawo lachiwiri la mankhwalawa limayendera limodzi ndi kuchuluka kwa mahomoni omwe amaperekedwa. Wodwalayo amabweretsedwa pamkhalidwe wodabwitsa, momwe amachotsedwera pambuyo pa kotala la ora limodzi ndi kulowetsedwa kwa shuga ndi insulin.
Panthawi yovuta kwambiri, wodwalayo amatha kugona, osasamala poyankha ululu, kapena, mutatembenuka mosalekeza
Gawo lachitatu ndilovuta kwambiri. Mlingo ukuwonjezereka mpaka pomwe wodwalayo amakhala pamalire pakati pa zozizwitsa komanso zikomokere (mwa anthu wamba anganene kuti "mankhwala osokoneza bongo" achitika). Pambuyo pa theka la ola, wodwalayo amachotsedwanso m'matenda a glucose omwe amapezeka ndi insulin.
Magawo otere ayenera kukhala osachepera 20. Komanso, kuchuluka kwa mankhwala omwe amathandizidwa kumachepetsedwa, ndikuchotsa kwathunthu.
Mavuto a Insulin Therapy
Zovuta zomwe zingachitike komanso zovuta zomwe zimachitika zimatha kukhala zowawa komanso zotupa pamalo a jekeseni, mawonekedwe a mkwiyo. Pa akatswiri othandiza odwala matenda ashuga, lipodystrophy imatha kuwoneka m'malo ena a mpanda wam'mimba, ntchafu, ndi matako.
Kugwiritsa ntchito molondola njira yoyenera kuwerengera, kuyambitsa kuchuluka kwa timadzi tambiri timene kumayambitsa matenda a hypoglycemia (shuga ya m'magazi amatsika kwambiri, komwe kumatha kuyambitsa kuphwanya). Zizindikiro zoyambira:
- thukuta
- matenda a m'matumbo;
- miyendo yanjenjemera, milomo;
- kuchuluka kwa mtima.
A pathological mkhalidwe amathanso kuchitika motsutsana ndi maziko a kuphatikiza kwa insulin mankhwala ndi zochitika zovuta, matenda opatsirana, kuchuluka kwa matenda osachiritsika, kuchita zolimbitsa thupi kwambiri.