Matenda a shuga a insulin

Pampu ya insulin ndi chipangizo chomwe insulin imalowetsedwa pansi pa khungu la wodwala. Zimagwira zokha, kuti jakisoni, wodwala safunika kuchitapo kanthu, ingokhazikitsa zoikika zomwe mukufuna ndikukonza gawo lazida. Pampu, monga lamulo, sizimayambitsa chisangalalo m'moyo watsiku ndi tsiku, chifukwa zimalemera pang'ono, ndipo jakisoni wochepetsetsa yemwe amapanga amakhala ngati wopanda ululu. Chipangizocho chimakhala ndi chosungira chokhala ndi insulini, singano yopyapyala kwambiri yoperekera mahomoni, pampu yokhala ndi purosesa komanso pampu yoperekera mankhwala, komanso chubu chopyapyala chomwe chimalumikiza izi.

Zambiri pazida

Mu insulin mapampu insulin yochepa kapena ya ultrashort yokha imagwiritsidwa ntchito. Mitundu iyi ya mahomoni imakomedwa ndi thupi, motero odwala amatha kukhalabe ndi shuga komanso kupewa misempha komanso zovuta zina za matenda ashuga. Pazotsatira za jakisoni wa classical, odwala nthawi zambiri amagwiritsa ntchito mitundu yambiri ya insulin yomwe imatenga nthawi yayitali. Sikuti mankhwalawa omwe ali ndi bioavailability ofunikira, ndipo nthawi zina kuchuluka kwa mayeso awo sikuposa 50-52%. Ndi chifukwa cha izi kuti odwala ali ndi hyperglycemia yosakonzekera (kuchuluka kwa glucose kuposa kwachilendo).

Zomwezo zimagwiranso ntchito zolimbitsa thupi, momwe kufunika kwa insulin kumasinthira. Kusintha kwa njira za jakisoni kumapangitsa kuti odwala azikhala mophweka komanso kuiwala za matenda pang'ono. Inde, kugwiritsa ntchito pampu sikuletsa zakudya ndi malingaliro a dokotala ena, koma ndi chipangizochi munthu amakhala ndi mwayi wambiri wodziyang'anira payekha ndikusintha kwakanthawi kamankhwala.

Njira zoyendetsera

Pampu imatha kugwira ntchito ziwiri zazikulu: mabasi ndi basal. Choyambirira ndi insulin yofulumira yomwe imakhala ngati jekeseni ndi syringe yokhazikika. Njirayi imakhala yoyenera nthawi zina pomwe wodwala amadya chakudya chambiri komanso amapatsa mphamvu zambiri zama protein ndi mafuta. Kukhazikika kwa mahomoni kumakupatsani mwayi kuti mubwezeretse msanga shuga mwambiri.

M'mapampu ambiri, mtundu wa bolus umatha kukhazikitsidwa payekhapayekha, ndikuusintha malinga ndi kuchuluka kwa chakudya. Ngati ndi kotheka, jakisoni amatha kupuma kapena kusintha kusintha kwa mahomoni omwe amaperekedwa. Kugwiritsa ntchito kwawoko kwa kachipangizoka kumayerekezera kupangidwa kwa insulini ndi kapamba poyankha kulowetsedwa kwa chakudya m'thupi.

Palinso mtundu wina wa ntchito pampu, momwe umalowetsera insulin m'magazi molingana komanso mosasamala tsiku lonse. Ndi njirayi, chipangizocho chimagwira ngati kapamba wa munthu wathanzi (ntchito zoyambira zimakopera). Mwanjira imeneyi, kuchuluka kwa ma insulin oyang'anira kungasinthidwe, kumasinthidwa malinga ndi zomwe wodwala akuchita, nthawi yogona komanso kupumula, lembani kuchuluka kwake.

Malangizo oyenera a insulin oyang'anira insulin amatha kusankhidwa ndikukonza zomwe zikuwonetsa ndi glucometer ndikuwunika momwe thupi

Pali ma pampu momwe sensor yothandizira glucose imalumikizidwa kale. Potere, pambuyo pa muyeso, mulingo wa shuga wamagazi amawonetsedwa panthawi yomwe njirayi idakonzedwa. Ngati izi sizigwiritsidwa ntchito mu chipangizo, ndiye kuti mu magawo oyamba kugwiritsa ntchito pampu, wodwalayo ayenera kugwiritsa ntchito glucometer wamba nthawi zambiri. Izi ndizofunikira kuti mumvetsetse momwe mulingo wa glycemia umasinthira ndi mitundu yosiyanasiyana ya insulin.

M'mapampu ambiri a insulini, mutha kupulumutsa modekha momwe mungayang'anire oyang'anira mahomoni a basal. Nthawi zosiyanasiyana masana, kuchuluka kwa jakisoni ndi Mlingo wambiri wa insulin kungafunike, kotero kupezeka kwa ntchitoyi ndikofunikira kwambiri. Ubwino wabwino wa njira yogwiritsira ntchito pampu ndikuchepetsa chiopsezo cha hypoglycemia.

The kusiyanasiyana kumwa woyambira kumwa insulin

Kufunika kwa thupi ka insulin sikumakhala kofanana nthawi zonse, ngakhale tikulankhula za munthu yemweyo. Zimatengera zaka, zaka zamagulu olimbitsa thupi, zochitika zolimbitsa thupi, mkhalidwe wamaganizo ndi zina zambiri.

Mwachitsanzo, zokhudzana ndi zaka zitha kukhudza kwambiri kuchuluka kwa mankhwala omwe wodwala amafunikira. Chifukwa chake, mu makanda ndi ana mpaka zaka 3, kufunikira kwa insulin kumachepetsedwa pang'ono usiku, kotero kwa iwo mbiri yapa basal imapangidwa mwanjira yoti kuchuluka kwa mahomoni kumakhala kochepa maola awa. Kwa achinyamata, mmalo mwake, chifukwa cha mphamvu yogwira mahomoni okula, kuchuluka kwa insulin usiku kuyenera kuchulukitsidwa. M'mawawa, pamene zochitika za "m'mawa kutacha" (kuchuluka kwa shuga) zimawonedwa mwa anthu akuluakulu odwala matenda ashuga, mankhwalawa amafunikanso kuwonjezeka pang'ono.

Mukawerengera kuchuluka kwa insulin yomwe imayendetsedwa, zotsatirazi ziyenera kuganiziridwa:

• zaka wodwala ndi kukula kwake kwa mahomoni;
• kukhalapo kwa zodwala matenda opatsirana;
• kulemera kwa thupi;
• kumwa mankhwala ena aliwonse;
• zochitika zatsiku ndi tsiku (maola ogwirira ntchito, kupumula ndi maola ochuluka olimbitsa thupi);
• kukhalapo kwa kupsinjika;
• magawo a msambo mu msambo wa akazi.

Kuwongolera mlingo wa mankhwalawa ungafunike musanasewere masewera, poyendetsa galimoto kwa nthawi yayitali, kupita kudziko lina kosiyana nyengo.

Zotheka

Kodi ndingabayireko insulin

Zofunika pampu - ichi ndi chida cha insulin, singano, catheters ndi machubu owonda osinthika omwe mankhwalawo amasamutsidwa. Zinthu zonsezi (kupatula chosungira cha mahomoni) ziyenera kusinthidwa kamodzi pakatha masiku atatu. Chidebe cha mahomoni chimatha kusinthidwa pafupifupi nthawi imodzi m'masiku 10. Izi zikuyenera kuchitika pofuna kupewa matenda ndikutukuka kwa njira yotupa m'mitsempha yamagazi ndi pakhungu.

Zinthu zina zothandizira pakugwiritsa ntchito pampuyi ndi monga mabatire, tepi yomatira ndi zigawo kuti zithetsedwe. Musanagwiritse ntchito chipangizocho, insulin iyenera kuwonjezeredwa kwa iwo. Kuti muchite izi, chotsani piston mu chidebe cha mahomoni (njirayi iyenera kubwerezedwa masiku onse atatu ndi chosungira chatsopano), ndipo singano imayikidwa mu ampoule ndi mahomoni. Mpweya umalowetsedwa kuchokera kuchosungira ndikuzaza ndi mankhwalawo, ndipo insulin imatengedwa pogwiritsa ntchito piston. Pambuyo pake, singano imachotsedwa, mpweya wambiri umamasulidwa ndipo piston imachotsedwa.

Chotengera chodzazidwa chimaphatikizidwa ndi chubu yosinthika, ndipo chidacho chimayikidwa pampu. Pofuna kuti insulini iwoneke mu cannula (chubu), imapunthidwa pamenepo isanakwane gawo lolozera chida pa thupi la munthu. Pambuyo pake, kachipangizoko kamalumikizidwa ndi catheter, chomwe chimamangirizidwa pakhungu la wodwala.

Zizindikiro zogwiritsidwa ntchito

Chizindikiro chachikulu chogwiritsa ntchito pampu ndi mtundu 1 wa shuga. Ndikofunikira kuti wodwalayo afune kugwiritsa ntchito chipangizochi, chifukwa, mwanjira zina, chimatha kuthamanga posamalira chipangizocho, kuwerenga ndikukhazikitsa mawonekedwe amodzi, ndi zina. Zizindikiro zina zokuyikira chipangizocho ndi:

• shuga kwa ana;
• mimba, nthawi yobereka komanso nthawi yoyamwitsa odwala omwe adayamba matenda ashuga a 1 ngakhale mwana asanabadwe;
• pafupipafupi magawo a hypoglycemia;
• kwambiri mtundu 2 shuga, momwe wodwalayo amayenera kubayira insulin nthawi zonse;
• kuwonjezeka mwadongosolo kwa shuga m'mawa;
• chosakwanira chindapusa cha shuga ndi njira zakale zamankhwala.

Kugwiritsa ntchito pampu pa nthawi yomwe mayi ali ndi pakati kumatha kuyendetsa bwino shuga komanso kupewa zovuta za mayi ndi mwana wosabadwayo: kusokonezeka ndi njira zambiri pakubala

Mapindu ake

Mapampu a insulini ayamba kutchuka kwambiri pakati pa odwala matenda ashuga padziko lonse lapansi. Izi ndichifukwa chakugwiritsa ntchito mosavuta komanso kosavuta kugwiritsa ntchito. Kugwiritsa ntchito mapampu a insulini kumatsegula mwayi woti anthu odwala matenda ashuga:

• kusiyanasiyana zakudya chifukwa cha kuthekera kusintha kosavuta kwa mlingo ndi insulin makonzedwe;
• sankhani mulingo woyenera wa insulin ndi masitepe ocheperako (0,1 PESCES poyerekeza ndi 0 PIECES mu ma insulin ndi zolembera)
• kuchita zolimbitsa thupi popanda zokhazikika zokhazikika;
• pewani kupweteka pakubaya ndi jakisoni ndi lipodystrophy pamalo a jakisoni;
• matenda a glycated hemoglobin (kusintha kwa chizindikirochi kumachepetsa chiopsezo cha zovuta kuchokera kumanjenje ndi mtima);
• khalani ndi mulingo wama glucose osasintha mwadzidzidzi.

Pampu idapangidwa mwanjira yoti muzitha kusamba ndi kusamba nayo, koma simuyenera kuyinyowetsa mwapadera kapena kuchita nawo masewera olimbitsa thupi ndi madzi

Pampu imathandizira kwambiri chithandizo cha ana omwe ali ndi matenda ashuga. Itha kugwiritsidwa ntchito kuyambira paukhanda, chifukwa cha kuwerengera kolondola kwa insulin pansi pa khungu. Zimakhala zovuta kwa ana aang'ono omwe amapita ku sukulu ya kindergarten, ndipo kenako sukulu, kuzolowera kufunika koti atenge jakisoni wa mahomoni. Amamva kupweteka kwambiri ndipo samamvetsetsa bwino kufunika kwa chithandizo chamankhwala. Chifukwa cha pampu ya insulin, makolo angatsimikize kuti mwana amalandira mlingo woyenera wa mankhwala panthawi yake popanda kupweteka.

Opanga chida ichi adasamaliranso odwala matenda ashuga kwambiri. Wodwala sawona bwino, amatha kugwiritsa ntchito pampu yokhala ndi masensa omvera omwe angakuwuzeni ngati atawerenga molondola kuchuluka kwa timadzi tambiri. Chipangizocho chikutha kutsimikizira magwiritsidwe ake a insulini pamawonekedwe omveka, mwakutero kuwongolera ntchitoyi kwa odwala omwe ali ndi vuto la ophthalmological.

Zoyipa

Choipa chachikulu cha pampu ya insulin ndi mtengo wake wokwera. Kuphatikiza apo, mtengo woyamba wa chipangizocho ndikuwukonzanso ndi wokwera mtengo. Zogwiritsidwa ntchito chifukwa chake (ma reservoirs, cannulas, catheters) ndi okwera mtengo kwambiri kuposa ma insulini ndi syringes wamba. Koma ngati wodwala ali ndi mwayi wogula chipangizochi, nthawi zambiri, ndi bwino kuchichita. Zitha kusintha bwino moyo wake ndikuwongolera zochitika za tsiku ndi tsiku zokutsutsa matenda ashuga.

Zina zokhudzana ndi kugwiritsa ntchito pampu ndi izi:

• zoletsa zina zokhudzana ndi kuvala kwa pampu kosalekeza (wodwalayo amafunikira chisamaliro ndi kulondola kuti asawononge mwangozi);
• kufunika kowerenga makonzedwe mwatsatanetsatane, kumvetsetsa njira zoyendetsera ntchito ndikusankha njira zabwino zowongolera insulin (kugwiritsidwa ntchito molakwika kwa chipangizocho kungayambitse kuwonongeka kwa mkhalidwe wa wodwalayo komanso kukula kwa matenda);
• chiwopsezo cha kuthira madzi osungirako ndi insulin (kuti mupewe izi, muyenera kuyang'anira mosamala kuchuluka kwa mahomoni mkati mwake ndikuwabwezeretsa panthawi yake);
• chiopsezo chowonongeka pa chipangizocho.

Mapampu amakono ambiri a insulin akhala akugwira ntchito moyenera kwa zaka zambiri, ndipo nthawi zambiri amalephera. Komabe, muyenera kumvetsetsa kuti chipangizo chilichonse chitha kugumula, kotero panthawi yakukonzekera wodwalayo angafunike jakisoni wambiri wa insulin ndi syringe.

Opanga ena amapereka m'malo mwaulere pampu ikasweka, koma ndibwino kufunsa za malingaliro awa musanagule.

Mukamasankha chida, muyenera kusamala ndi kupezeka kwa ntchito monga kusinthasintha kusinthasintha kwa gawo la glycemia, kutsekereza zokha, kuthekera kosunga mawonekedwe ndikuyika masitepe ochepa mukasankha

Zowonjezera zamapampu amakono

Opanga mapampu a insulin akuyesera kuti athandizike kwambiri komanso kuti azigwira bwino ntchito kwa odwala matenda ashuga. Ichi ndichifukwa chake kuwonjezera pa ntchito zofunikira pazida izi, mutha kupeza zosankha zambiri. Mwachitsanzo, kuwerengera kwotsalira kwa insulini m'magazi kumathandiza wodwala kuwerengera nthawi ndi mlingo wa kuphatikiza kwa mahomoni. Kudziwa kuti insulini yomwe idagwiritsidwapo ntchito nthawi yathayi ikugwirabe ntchito, mutha kupewa kuchulukana kosafunikira kwa thupi ndi mankhwalawa. Kuzungulira kwa mahomoni m'mwazi kumawonetsedwa, zomwe zimapangitsa kuti odwala matenda ashuga azilamulira bwino vutoli.

Komanso, chipangizocho chitha kukhazikitsidwa pazowonjezera zina:

• kuwerengetsa basi kuchuluka kwa insulini wotsatira lotsatira bolus zochokera deta analowera kuchuluka kwa chakudya mu chakudya amene wodwalayo akufuna kudya;
• kulunzanitsa ndi kompyuta kuti ikhale yosavuta yosungirako deta ndi ziwerengero;
• kusinthanitsa kwa data pakati pa pampu ndi glucometer kuti muwerenge kuchuluka kwa insulin yomwe imayendetsedwa;
• kutulutsa pampu pogwiritsa ntchito njira yapadera yakutali;
• kupereka machenjezo opangira chenjezo ngati mungadumphe ziboliboli, kudumphira magazi poyesa shuga, ndi zina zambiri.

Pali zomwe zikukuthandizani kuti mulowe mothandizidwa ndi pampu osati insulin yokha, komanso mankhwala "Simlin" ("Pramlintid"). Ichi ndi mahomoni omwe amachititsa kuti azitha kuwongolera bwino magazi pambuyo kudya. Chidachi chimathandizanso kuchepetsa kunenepa komanso kuchepetsa matenda a glycated hemoglobin.

Zovuta zakugwiritsa ntchito pampu ya insulin ndizochepa - zitha kugwiritsidwa ntchito ndi anthu onse odwala matenda ashuga, kupatula kwa odwala omwe ali ndi vuto lowonera komanso matenda amisala. Chaka chilichonse, odwala matenda ashuga ambiri akuyamba kugwiritsa ntchito chipangizochi. Izi zimachitika chifukwa chogwiritsa ntchito mosavuta, kuchepetsa mwayi wokhala ndi zovuta za matendawa komanso kukonza moyo wabwino. Pampu imakulolani kuti musaganize zamatendawa mphindi iliyonse, chifukwa cha chipangizochi munthu amatha kudya zakudya zamitundu yambiri, amatsogolera njira yodziwika komanso kusewera masewera popanda ngozi ya hypoglycemia.