Insulin ndi timadzi tomwe timagwira ntchito zingapo nthawi imodzi - timaphwanya shuga m'magazi ndikuupereka kwa maselo ndi minyewa ya thupi, potero imawakhutitsa ndi mphamvu yofunikira kuti igwire ntchito bwino. Hormoneyi ikakhala yoperewera m'thupi, maselo amaleka kulandira mphamvu zochuluka mulingo woyenera, ngakhale kuti kuchuluka kwa shuga m'magazi kumakhala kwakukulu kwambiri kuposa kwazonse. Ndipo munthu akaonetsa zovuta zotere, amapatsidwa mankhwala a insulin. Amakhala ndi mitundu ingapo, ndipo kuti mumvetsetse bwino kuti insulini ndiyabwino, ndikofunikira kulingalira mwatsatanetsatane mitundu yake ndi madigiri akuwonekera kwa thupi.
Zambiri
Insulin imagwira ntchito yofunika kwambiri m'thupi. Tili othokoza kuti maselo ndi minyewa ya ziwalo zamkati zimalandira mphamvu, chifukwa chomwe zimatha kugwira bwino ntchito ndikugwira ntchito yawo. Zikondwererozi zimaphatikizidwanso pakupanga insulin. Ndipo ndikukula kwa matenda aliwonse omwe amachititsa kuti maselo ake awonongeke, amayamba chifukwa chakuchepa kwa kapangidwe ka timadzi tambiri timeneti. Zotsatira zake, shuga omwe amalowa mthupi mwachindunji ndi chakudya samapukusika ndipo amakhala m'magazi momwe amapangira michere. Ndipo chimayamba matenda a shuga.
Koma ndi zamitundu iwiri - yoyamba ndi yachiwiri. Ndipo ngakhale ndi T1DM pali kusowa kwa pancreatic pang'ono, ndiye kuti ndi matenda amtundu wa 2 pali zovuta zina zakusiyana mthupi. Zikondazo zimapitilizabe kupanga insulini, koma maselo amthupi amasiya kuzimva, chifukwa amasiya kuyamwa mphamvu zonse. Potengera maziko awa, shuga samatha mpaka kumapeto komanso amakhazikika m'magazi.
Koma nthawi zina, ngakhale ndi mtundu wachiwiri wa matenda ashuga, kudya sikumapereka zotsatira zabwino, chifukwa kapamba “amatopa” pakapita nthawi komanso amaleka kupanganso timadzi tambiri tambiri. Pankhaniyi, kukonzekera kwa insulin kumagwiritsidwanso ntchito.
Amapezeka m'mitundu iwiri - mapiritsi ndi mayankho a intradermal management (jekeseni). Ndipo polankhula za zomwe zili bwino, insulini kapena mapiritsi, ziyenera kudziwidwa kuti majekeseni ali ndi chiwonetsero chachikulu kwambiri mthupi, chifukwa zomwe zimagwira zimathandizira kulowa mu kayendedwe kazinthu ndikuyamba kugwira ntchito. Ndipo insulini m'mapiritsi imayamba kulowa m'mimba, kenako imayamba kugwira ntchito ndipo kenako imalowera m'magazi.
Kugwiritsa ntchito kukonzekera kwa insulin kuyenera kuchitika pokhapokha mukaonana ndi katswiri
Koma izi sizitanthauza kuti insulini m'mapiritsi ilibe ntchito zochepa. Zimathandizanso kuchepetsa shuga m'magazi ndipo zimathandizanso kukonza zomwe wodwalayo ali nazo. Komabe, chifukwa chochepa pang'onopang'ono, sioyenera kugwiritsidwa ntchito mwadzidzidzi, mwachitsanzo, poyambika kwa hyperglycemic coma.
Gulu
Gulu la insulin ndilabwino kwambiri. Amagawidwa malinga ndi mtundu wa zomwe adachokera (zachilengedwe, zopangidwa), komanso kuchuluka kwa kuyambitsa kulowa m'magazi:
- mwachidule
- sing'anga;
- lalitali.
Kuchita insulin mwachidule
Insulin yochepa-yankho ndi yankho la crystalline zinc-insulin. Chomwe chimasiyanitsa ndikuti zimagwira mthupi la munthu mwachangu kwambiri kuposa mitundu ina ya kukonzekera kwa insulin. Koma nthawi yomweyo, nthawi yawo yochita umatha mwachangu momwe zimayambira.
Mankhwalawa amalowetsedwa subcutaneous theka la ola musanadye njira ziwiri - intradermally kapena intramuscularly. Kuchuluka kwa kugwiritsidwa ntchito kwawo kumatheka pambuyo pa maola 2-3 mutatha kutsata. Monga lamulo, mankhwala osokoneza bongo omwe amagwiritsidwa ntchito posachedwa amagwiritsidwa ntchito limodzi ndi mitundu ina ya insulin.
Insulin Yapakatikati
Mankhwalawa amasungunuka pang'ono pang'onopang'ono minofu yaying'ono ndipo amatengeka ndikuyenderera bwino, chifukwa omwe amakhala ndi mphamvu kwambiri kuposa ma insulin omwe amangokhala osachita kanthu. Nthawi zambiri machitidwe azachipatala, insulin NPH kapena tepi ya insulin imagwiritsidwa ntchito. Yoyamba ndi yankho la makristasi a zinc-insulin ndi protamine, ndipo chachiwiri ndi chosakanikirana chomwe chimakhala ndi kristalo ndi amorphous zinc-insulin.
Limagwirira zake zochita insulin
Insulini yapakatikati ndiyachinyama ndi anthu. Ali ndi ma pharmacokinetics osiyanasiyana. Kusiyana pakati pawo ndikuti insulin yakuchokera kwa anthu imakhala ndi hydrophobicity yapamwamba kwambiri ndipo imagwirizana bwino ndi protamine ndi zinc.
Pofuna kupewa zoyipa zomwe zimagwiritsidwa ntchito ndi insulin ya nthawi yayitali yochitapo kanthu, iyenera kugwiritsidwa ntchito mosamalitsa malinga ndi chiwembu - 1 kapena 2 kawiri pa tsiku. Ndipo monga tafotokozera pamwambapa, mankhwalawa nthawi zambiri amaphatikizidwa ndi ma insulin achidule. Izi ndichifukwa choti kuphatikiza kwawo kumapangitsa kuti mapuloteni azisakanikirana bwino ndi zinc, chifukwa chomwe kunyowa kwa insulin yocheperako kumachepetsedwa kwambiri.
Kuchita insulini kwa nthawi yayitali
Gulu la mankhwala omwe ali ndi mankhwala ali ndi kuyamwa pang'ono pang'onopang'ono m'magazi, motero amachitapo kanthu kwa nthawi yayitali. Izi amachititsa kuti magazi azikhala ndi shuga tsiku lililonse. Zimayambitsidwa nthawi 1-2 patsiku, mlingo wake umasankhidwa payekhapayekha. Zitha kuphatikizidwa ndi insulin yochepa komanso yapakatikati.
Njira zogwiritsira ntchito
Mtundu wa insulini yotani ndi kuchuluka kwake, ndi dokotala yekhayo amene amasankha, potengera zomwe wodwalayo ali nazo, kuchuluka kwa kuchuluka kwa matenda komanso kupezeka kwa zovuta ndi matenda ena. Kuti mudziwe kuchuluka kwake kwa insulini, ndikofunikira kuyang'anitsitsa kuchuluka kwa shuga m'magazi pambuyo pa kayendetsedwe kake.
Malo abwino kwambiri a insulin ndi khola lam'madzi pamimba.
Ponena za mahomoni omwe amayenera kupangidwa ndi kapamba, kuchuluka kwake kuyenera kukhala pafupifupi magawo 30 mpaka 40 patsiku. Zomwezo zimafunikira kwa odwala matenda ashuga. Ngati ali ndi vuto losakwanira pancreatic, ndiye kuti mlingo wa insulini ungafike pamagawo 30-50 patsiku. Nthawi yomweyo, 2/3 yake iyenera kugwiritsidwa ntchito m'mawa, ndi nthawi yonse yamadzulo, chakudya chisanachitike.
Malangizo abwino kwambiri omwera mankhwalawa amadziwika kuti amaphatikiza insulin yochepa komanso yapakati. Mwachilengedwe, njira yogwiritsira ntchito mankhwalawa imadaliranso izi. Nthawi zambiri pamachitidwe otere, njira zotsatirazi zimagwiritsidwa ntchito:
- kugwiritsa ntchito munthawi yomweyo mankhwala osokoneza bongo a insulin pamtunda wopanda kanthu m'mawa asanadye chakudya cham'mawa, ndipo madzulo kumangokhala mankhwala osakhalitsa (musanadye chakudya chamadzulo) amawayika ndikatha maola ochepa - oyambira;
- Mankhwala okhala ndi kanthu kwakanthawi amagwiritsidwa ntchito tsiku lonse (mpaka kanayi pa tsiku), ndipo asanagone, jakisoni wa mankhwala a nthawi yayitali kapena yayifupi amatumizidwa;
- pa 5-6 m'mawa insulin ya sing'anga kapena nthawi yayitali imalowetsedwa, ndipo musanadye chakudya cham'mawa komanso chilichonse cham'tsogolo - lalifupi.
Ngati dotolo adapereka mankhwala amodzi kokha kwa wodwala, ndiye kuti ayenera kugwiritsidwa ntchito mosamalitsa. Chifukwa, mwachitsanzo, insulin yochepa imayikidwa katatu patsiku masana (omaliza asanagone), pakati - kawiri pa tsiku.
Zotsatira zoyipa
Mankhwala osankhidwa moyenera komanso mlingo wake pafupifupi sizipangitsa kukhalapo kwa mavuto. Komabe, pali zochitika zina pamene insulin yokha siyili yoyenera kwa munthu, ndipo pamenepa mavuto ena angabuke.
Kupezeka kwa zotsatira zoyipa mukamagwiritsa ntchito insulin nthawi zambiri kumayenderana ndi kupezeka kwa mankhwala osokoneza bongo, kosayenera pakukonzekera kapena kusungidwa kwa mankhwalawa
Nthawi zambiri, anthu amasintha okha mwanjira, akumachulukitsa kapena kuchepetsa kuchuluka kwa insulini, zomwe zimapangitsa kuti azisangalatsidwa. Kuchulukitsa kapena kutsika kwa mankhwalawa kumabweretsa kusinthasintha kwa shuga wamagazi mbali imodzi kapena imodzi, mwakutero kumapangitsa kukula kwa hypoglycemic kapena hyperglycemic coma, yomwe imatha kubweretsa mwadzidzidzi.
Vuto lina lomwe odwala matenda ashuga amakumana nalo nthawi zambiri ndimatsoka lomwe limachitika chifukwa cha nyama. Zizindikiro zawo zoyambirira ndizowoneka ngati kuyabwa ndi kuwotcha pamalo a jekeseni, komanso khungu la khungu ndi kutupa kwawo. Zikakhala kuti zizindikiro ngati izi zikuwoneka, muyenera kufunsa chithandizo kuchokera kwa dokotala ndikusintha kuti mupeze insulin kuchokera kwa anthu, koma nthawi yomweyo muchepetseni.
Atrophy ya adipose minofu ndi vuto lofanananso kwa odwala matenda ashuga ndi kugwiritsa ntchito insulin nthawi yayitali. Izi zimachitika chifukwa chakuwongolera pafupipafupi kwa insulin pamalo amodzi. Izi sizimayambitsa mavuto ambiri kuumoyo, koma malo omwe jakisoni amayenera kusinthidwa, popeza mulingo wawo wolowetsa umakhala wolakwika.
Pogwiritsa ntchito insulin kwa nthawi yayitali, mankhwala osokoneza bongo amathanso kuchitika, omwe amawonetsedwa ndi kufooka kwa mutu, kupweteka mutu, kutsika kwa magazi, ndi zina zambiri. Ngati muli ndi bongo wambiri, muyenera kufunsa dokotala nthawi yomweyo.
Mwachidule
Pansipa tikambirana mndandanda wa mankhwala omwe amapezeka ndi insulin omwe amagwiritsidwa ntchito nthawi zambiri pochiza matenda a shuga. Zimaperekedwa pazidziwitso zokhazokha, simungathe kuzigwiritsa ntchito popanda chidziwitso cha dokotala mulimonse. Kuti ndalamazo zigwire bwino ntchito, ziyenera kusankhidwa mokhazikika!
Chichewa
Yabwino kwambiri yochezera pang'ono insulin. Muli insulin yaumunthu. Mosiyana ndi mankhwala ena, amayamba kuchita zinthu mwachangu kwambiri. Pambuyo pakugwiritsidwa ntchito, kuchepa kwa shuga m'magazi kumawonedwa pambuyo pa mphindi 15 ndikukhalabe mkati mwa malire ena kwa maola atatu.
Humalog mu mawonekedwe a cholembera
Zizindikiro zazikulu pakugwiritsira ntchito mankhwalawa ndi matenda ndi zinthu zotsatirazi:
- matenda a shuga omwe amadalira insulin;
- thupi lawo siligwirizana kukonzekera insulin;
- hyperglycemia;
- kukana kugwiritsa ntchito mankhwala ochepetsa shuga;
- shuga wodalira insulin asanafike opaleshoni.
Mlingo wa mankhwalawa amasankhidwa payekha. Kumayambiriro kwake kumatha kuchitika zonse ziwiri komanso m'njira zamitsempha. Komabe, kupewa mavuto kunyumba, tikulimbikitsidwa kupaka mankhwala pokhapokha musanadye.
Mankhwala osokoneza bongo amakono, kuphatikiza Humalog, ali ndi zotsatira zoyipa. Ndipo pankhaniyi, odwala motsutsana ndi momwe amagwiritsidwira ntchito nthawi zambiri amakhala ndi vuto, kutsika kwa masomphenya, chifuwa ndi lipodystrophy. Kuti mankhwala azigwira ntchito pakapita nthawi, ayenera kusungidwa bwino. Ndipo izi ziyenera kuchitidwa mufiriji, koma siziyenera kuloledwa kuziziritsa, chifukwa pamenepa malonda amataya katundu wake wochiritsa.
Insuman Rapid
Mankhwala ena okhudzana ndi insulin yochepa yochita potengera timadzi ta munthu. Mphamvu ya mankhwalawa imafika pachimake patatha mphindi 30 kuchokera pakukonzekera ndipo imapereka chithandizo chokwanira kwa thupi kwa maola 7.
Insuman Rapid ya subcutaneous makonzedwe
Chochita chimagwiritsidwa ntchito mphindi 20 musanadye chilichonse. Pankhaniyi, tsamba la jakisoni limasintha nthawi iliyonse. Simungapereke jakisoni m'malo awiri. Ndikofunikira kuti musinthe nthawi zonse. Mwachitsanzo, nthawi yoyamba imachitika m'chigawo chamapewa, chachiwiri m'mimba, chachitatu pamatako, ndi zina. Izi zimapewe kuphwanyidwa kwa minofu ya adipose, yomwe wothandizirayo amakwiya.
Biosulin N
Mankhwala osokoneza bongo omwe amalimbikitsa chinsinsi cha kapamba. Ili ndi mahomoni ofanana ndi anthu, omwe amalekeredwa mosavuta ndi odwala ambiri ndipo sasokoneza maonekedwe. Zochita za mankhwalawa zimachitika ola limodzi pambuyo pakukonzekera ndikufika pachimake patatha maola 4-5 jekeseni. Imakhalabe yothandiza kwa maola 18-20.
Zingachitike kuti munthu atalowetsa mankhwalawa ndi mankhwala ofanana, ndiye kuti akhoza kudwala hypoglycemia. Zinthu monga kupsinjika kwambiri kapena kudya zakudya zodumphadwala kumatha kuyambitsa kuwonekera kwake atagwiritsidwa ntchito ndi Biosulin N. Chifukwa chake, ndikofunikira kwambiri mukamagwiritsa ntchito pafupipafupi kuyeza misempha ya magazi.
Gensulin N
Zimatanthauzira ma insulin apakati omwe amawonjezera kupanga kwa maholide a pancreatic. Mankhwalawa amaperekedwa mosavuta. Kugwiranso ntchito kwake kumapezekanso ola limodzi pambuyo pa kukhazikitsa ndipo kumatenga maola 18-20. Nthawi zambiri zimayambitsa kupezeka kwa zovuta ndipo zimatha kuphatikizidwa mosavuta ndi ofalitsa omwe amakhala osakhalitsa kapena otenga nthawi yayitali.
Zosiyanasiyana zamankhwala Gensulin
Lantus
Insulin yayitali, yomwe imagwiritsidwa ntchito kuwonjezera pancreatic insulin secretion. Zovomerezeka kwa maola 24 mpaka 40. Mphamvu yake yokwanira imatheka patadutsa maola awiri pambuyo pa makonzedwe. Imaperekedwa nthawi imodzi patsiku. Mankhwalawa ali ndi mawonekedwe ake, omwe ali ndi mayina otsatirawa: Levemir Penfill ndi Levemir Flexpen.
Levemir
Mankhwala ena omwe akhala akuchita kwa nthawi yayitali omwe amagwiritsidwa ntchito mwachangu kuchepetsa shuga m'magazi a shuga. Kuchita kwake kumakwaniritsidwa patatha maola 5 mutatha kuyang'anira ndipo kumapitilira tsiku lonse. Makhalidwe a mankhwalawa, omwe amafotokozedwa patsamba lovomerezeka la wopanga, akuwonetsa kuti mankhwalawa, mosiyana ndi kukonzekera kwina kwa insulin, amatha kugwiritsidwa ntchito ngakhale mwa ana opitirira zaka 2.
Pali zokonzekera zambiri za insulin. Ndipo kunena kuti ndi yabwino kwambiri ndizovuta kwambiri. Tiyenera kumvetsetsa kuti chamoyo chilichonse chimakhala ndi zake ndipo m'njira zake zimagwirizana ndi mankhwala ena ake. Chifukwa chake, kusankha kwa insulin kukonzekera kuyenera kuchitika payekha komanso kokha ndi dokotala.