Kodi insulin ndi chiyani

Matenda a shuga ndi matenda oopsa omwe amakhudza anthu ambiri padziko lapansi. Choyipa chachikulu ndikuti pakati pawo si akulu okha ndi okalamba, komanso ana. Ndipo pochiza matenda awa, odwala nthawi zambiri amapatsidwa jekeseni wa insulin, omwe amaperekedwa mobwerezabwereza kangapo patsiku. Koma kodi insulin ndi chiani ndipo chifukwa chiyani thupi lathu limafunikira? Mudziwa za izi ndi zina zambiri.

Zambiri

Insulin ndi timadzi tina tomwe timapanga protein, momwe amapangira kapamba. Werengani zambiri za momwe amapangira mahomoni munkhaniyi. Kupanga kwake kumapangidwira chimodzimodzi panthawi yomwe kulumpha kwakuthwa m'magazi a glucose kumachitika m'magazi. Izi zimachitika, monga lamulo, munthu akangosiya kudya.

Koma nthawi yomweyo ndikofunikira kudziwa kuti zinthu zonse zimakhala ndi zotsatira zosiyanasiyana pa shuga wamagazi. Ena mwa iwo amakulitsa kuwonjezeka kwakukuru kuposa kwazonse, pomwe ena amawonjezera kuchuluka kwa shuga m'magazi pang'onopang'ono osati zochuluka.

Njirayi ndi yovuta, chifukwa insulini imayenera kupanga mafuta ambiri kuti ayambe, omwe amatenga nawo gawo limodzi pakupanga masitolo a glucose m'maselo a thupi. Ndipo nkhokwezi zikadzakhala zazikulu kwambiri, glucose ochulukanso amayamba kusinthidwa kukhala mafuta, pomwe amayika pamthupi momwe amapangira mafuta.

Glucose ndi chakudya chopatsa thanzi chomwe chimatha kukhala chosavuta kapena chovuta, chothamanga komanso chofulumira. "Zowopsa" kwambiri m'thupi ndizopatsa mphamvu mwachangu komanso zosavuta, zomwe kwa nthawi yochepa zimapangitsa maselo kukhala ndi glucose ndikupangitsa kuti asinthe kukhala mafuta. Zakudya zomanga thupi zotere zimapezeka muzakudya zonse zotsekemera ndi ufa, koloko komanso shuga wokhazikika. Amachulukitsa msanga wamagazi m'magazi ndipo amathandizira kupanga insulin, yomwe imathandizira kupangitsa mafuta.

Koma zonsezi sizimvetsetsa kwathunthu kuti kodi ndi insulin yamafuta ndani. Chifukwa chake, timaganizira izi mwatsatanetsatane.

Insulin ndiyachinyama komanso chopangidwa

Insulin zachilengedwe

Monga tafotokozera pamwambapa, insulini ndi timadzi tomwe timapangidwa mthupi mwathupi ndi kapamba. Munthu akangodya, zakudya zomwenso zimapatsidwa ndi iye nthawi yomweyo zimagwera mu glucose, womwe ndi gwero lamphamvu lamphamvu mthupi.

Subcutaneous Insulin Algorithm

Pofuna kuti isataye, insulin imaphatikizidwanso pantchito, yomwe imabwezeretsa mphamvu m'maselo. Koma njirayi imafunanso kutengapo gawo kwa mahomoni ena omwe amathandizira kuti insulini igwire ntchito yawo. Udindo wawo ndi glucagon ndi amylin.

Ngati imodzi mwazinthuzi ndi yoperewera, njira ya kuchuluka kwa glucose m'maselo imasokonekera. Thupi limayamba kuwona kuperewera mphamvu ndikuyesera kulipiritsa potentha maselo amafuta. Chifukwa chake, munthu amene ali ndi mavuto ngati amenewa amayamba kuchepa thupi msanga, ngakhale atakhala kuti amadya zakudya zamafuta ambiri komanso mafuta.

Pankhaniyi, kulumpha lakuthwa m'magazi a magazi kumachitika, komwe kumabweretsa kukula kwa hyperglycemia. Matendawa ndi owopsa, chifukwa angayambitse kukomoka pambuyo poti amwalira.

Kodi nchiyani chomwe chingayambitse kupanga kwa insulin? Zifukwa zake ndizambiri. Izi ndizosiyana pakapangidwe ka chiwalo, ndikupeza ma pathologies omwe amachititsa kuti maselo ake awonongeke, komanso zinthu zina zomwe zimapangitsa kuti katundu akhale wolimba kwambiri chifukwa zimatopa ndipo zimaleka kupanga insulin mokwanira.

Fomu lamankhwala

Insulin ya pancreatic imakhala ndi maselo ena ovuta. Koma kwakhala kwadziwika kwa asayansi athu, chifukwa chomwe anaphunzira kuzipanga, kupanga mankhwala ochulukirachulukira othandizira odwala a shuga ndi ana.

Ponena za kapangidwe ka mankhwala a insulin, ziyenera kudziwika kuti ili ndi ma amino acid ndipo ndi mtundu wa mahomoni a peptide omwe ali ndi maunyolo awiri a peptide, mapangidwe ake omwe amaphatikizapo zotsalira za amino acid (pali pafupifupi 51 a iwo). Maunyolo amtundu wa peptide amalumikizidwa ndi milatho yopanda discride, omwe amalembedwa mwanjira "A" ndi "B". Mlatho woyamba umaphatikizapo zotsalira za 21 amino acid, yachiwiri - 30.

Mitundu ya mankhwala a insulin

Dziwani kuti kapangidwe ka mahomoni amunthu ndikosiyana kwambiri ndi insulin ya nyama, mwachitsanzo, mahomoni anyani, omwe, amawoneka kuti, ali pafupi kwambiri ndi munthu kuposa zolengedwa zina. Chofanana kwambiri ndi insulin yamunthu ndi mahomoni a nkhumba. Kusiyana pakati pawo ndikungosowa kwa amino acid yotsalira mu unyolo "B".

Palinso nyama ina m'thupi yomwe imatulutsa insulin, yomwe imafanana ndi timadzi tambiri. Iyi ndi ng'ombe. Amangotsala 3 amino acid zotsalira. Nyama zotsalira zomwe zimakhala m'gulu la anyani amtunduwu zimatulutsa "insulin" yake, ndipo mwachilengedwe chake ndizosiyana kwambiri ndi anthu.

Ndi chifukwa cha ichi kuti zida za ng'ombe kapena za nkhumba zimakonda kugwiritsidwa ntchito kupanga mankhwala osokoneza bongo. Dziwani kuti ndi insulin ya nyama yomwe imalekeredwa bwino ndi odwala kuposa mankhwala opangidwa omwe ali ndi mawonekedwe ofanana a maselo ndi insulin yachilengedwe.

Insulin ndi matenda a shuga

Monga tanena kale, insulini ndiyo imayendetsa ndikusuntha kwa glucose m'maselo a thupi. Pakakhala vuto lililonse mu mahomoni kapena kapangidwe kake, matenda monga matenda a shuga amakula. Zimachitika m'mitundu iwiri - 1 ndi 2.

Ndi chitukuko cha matenda a shuga 1 amtundu, kupanga insulini mthupi kumachepa kapena kusiya kwathunthu, komwe kumakhudzana ndikuphwanya umphumphu wa maselo a pancreatic. Ndipo ndi T2DM, kupanga kwa timadzi timeneti kumachitika mwanjira yofananira, koma pazifukwa zina maselo amayamba kusiya kuzimvetsetsa ndikusiyira kuyanjana nawo. Chifukwa chake, thupi silingagwiritse ntchito bwino insulin komanso limayikanso m'magazi.

Limagwirira kukula kwa matenda ashuga

M'nkhani yoyamba komanso yachiwiri, munthu amafunika kugwiritsa ntchito mankhwala ochiritsira, popeza pakalibe glucose amayamba kudziunjikira m'magazi, zomwe zimasokoneza ntchito yonse ya thupi lonse.

Choyamba, kuchokera ku kuchuluka kwa shuga m'magazi:

• mtima (matenda a coronary amayamba, chiopsezo cha matenda a mtima ndi stroke chikuwonjezereka);
• ubongo (maselo a mu ubongo awonongeka, magwiridwe antchito amachepetsa, mavuto amachokera ku dongosolo lamagetsi amkati amawonekera);
• mtima wamitsempha yamagazi (zolengeza zimawoneka pamakoma amitsempha yamagazi);
• ulusi wamitsempha (mwa anthu, kuchepa kwa chidwi cha khungu);
• ziwalo zamawonedwe (mitsempha ya optic imawonongeka, yomwe imayambitsa kukula kwa retinopathy);
• impso (chiopsezo cha nephropathy, kulephera kwa impso, etc. zimachulukitsa);
• manambala (samachiritsa bwino, omwe amatsogolera kuoneka ngati zilonda zam'mimba ndi mawonekedwe a gangrene), etc.

Popeza mavuto onsewa, omwe angayambitse shuga wambiri, odwala matenda a shuga ayenera kuchitapo kanthu kuti achepetse matendawa. Ndipo izi zimafunikira insulini, yomwe imaphwanya glucose yomwe imalowa m'thupi ndi chakudya.

Dziwani kuti pamene mahomoniwa amapangidwa mwachilengedwe, umalowa m'mimba ndipo umayikidwamo momwemo ndi zinthu zina, kenako umalowa m'magazi. Chifukwa chake, kukonza zochita zambiri za mahomoni, madokotala amalimbikitsa kuti ziperekedwe mwachangu. Chifukwa chake imalowa m'magazi, pomwe imayamba kugwira ntchito zake.

Zochita za insulin

Ndikofunikanso kunena kuti thupi la munthu aliyense ndimunthu payekha ndipo ali ndi mawonekedwe ake. Zomwe zimapangitsa munthu kukhala ndi matenda ashuga nawonso ndi osiyana, ndipo moyo womwe amamutsatira umathandiza kwambiri pothana ndi matendawo. Ndipo ndikuthokoza kuti sayansi yatenga njira zambiri pakukula kwake, imapatsa anthu mitundu yopitilira 30 ya insulin, yomwe imakulolani kusankha mankhwala kwa wodwala aliyense.

Mwachilengedwe, mawonekedwe a mankhwalawa ndi osiyana, ndipo onse amachita m'njira zawo. Ena mwa iwo amakhala ndi zotulukapo zachangu, koma sakhalitsa, pomwe ena amangoyamba kugwira ntchito maola ochepa atangoyang'anira, koma amapatsa shuga wambiri tsiku lonse.

Mitundu ya Hormone

Ponena za zomwe zimachitika ndi insulin, ziyenera kudziwidwa kuti zimasiyana mwachangu. Chifukwa chake, lagawidwa mu:

• kuthamanga kwambiri;
• mwachidule
• sing'anga;
• chokhalitsa.

Insulin yochita zinthu mwachangu imayamba kugwira ntchito pambuyo pa mphindi 5 pambuyo pa kuperekedwa ndipo imakupatsani mwayi wochepetsa shuga m'magazi mpaka mphindi 10-15. Kuchuluka kwake kwa kuyambitsa kumachitika pambuyo pa ola limodzi, komabe, zotsatira zake zimatha mwachangu kwambiri. Kukhazikitsidwa kwa insulin yolimbikira ndikulimbikitsidwa ndi zakudya. Kutengera ndi kuopsa kwa matendawa ndi momwe wodwalayo alili, mahomoni olimbitsa thupi nthawi zambiri amathandizidwa limodzi ndi insulin.

Timadzi tating'onoting'ono timagwira ntchito mphindi 30 pambuyo pa kukhazikitsa. Jekeseni imatha kuperekedwa musanadye kapena musanadye. Ngakhale insulin iyi imayamba kugwira ntchito mphindi 25 pambuyo pochita mwachangu, imawonetsetsa kuti shuga yamagazi imasungidwa panthawi yochepa kwambiri.

Kuchita insulin mwachidule

Ma insulin omwe amagwiritsa ntchito nthawi zambiri amagwiritsidwa ntchito ndi mankhwala othamangira kapena osakhalitsa. Chifukwa chake, kuphatikiza kwakukulu kwa mankhwalawa kumatheka, ndipo kuchuluka kwa shuga m'magazi kumangosungidwa mkati mwa nthawi yochepa kwa maola pafupifupi 6-8.

Koma ma insulin omwe amakhala kwa nthawi yayitali amawonedwa kuti ndi othandiza kwambiri, chifukwa ndikokwanira kuwayika kamodzi kokha patsiku kuti atsimikizire kuchuluka kwa glucose m'magazi. Amapereka jakisoni wotere, monga lamulo, m'mawa pamimba yopanda kanthu komanso osakanikirana ndi ma insulin osakhalitsa.

Zokonzekera zomwe zimasakanikirana wina ndi mnzake makonzedwe asanaperekedwe samapitilira 2 pa tsiku. Komanso, jekeseni imachitika mphindi 15-20 musanadye. Koma ziyenera kudziwika kuti chiwalo chilichonse chimayankha mwa njira yake pokonzekera mankhwalawo. Zotsatira zake zimatanthauzanso mtundu wamakhalidwe omwe wodwalayo amakhala nawo, ngakhale atasewera kapena ayi, ali ndi zizolowezi zoyipa kapena ayi, etc. Ichi ndichifukwa chake ma insulini amasankhidwa mosiyanasiyana payekhapayekha, poganizira zinthu zonsezi.

Source ndi kapangidwe

Takambirana kale pamwambapa momwe insulini imakhudzira thupi la munthu ndi udindo wake. Tsopano zikulankhulabe za momwe timadzi timene timapangidwira komanso momwe limapangidwira. Zokonzekera zonse zozikika zimapezeka mu mawonekedwe amadzimadzi. Kupsinjika kwawo kungakhale kosiyana, koma chachikulu ndicho U-100 pa 1 ml.

Yankho la insulin palokha lilinso ndi zinthu zina zomwe zimateteza mankhwalawo pakukula kwa mabakiteriya owononga mmenemo ndikuthandizira kukhalabe ndi acid-base usawa.

Syulin yopanga insulin idapangidwa koyamba mu 1980. Anayamba kugwiritsa ntchito mankhwalawo mankhwalawa pofuna kuchiza matenda ashuga m'malo mwa mankhwala ochokera ku nyama. Koma popeza kuti zopangidwa sizimaleredwa bwino ndi odwala onse, ma insulin a nyama amagwiritsidwanso ntchito modzipereka pantchito zamankhwala mpaka lero.

Masamba obayira a insulin

Njira zakugwiritsira ntchito ndi mitundu

Ndi chitukuko cha matenda a shuga 1 amthupi mwa amayi ndi abambo, njira yochiritsira jakisoni wa insulin imalembedwa nthawi zonse. Pankhaniyi, dokotala amawerengera aliyense mlingo, womwe uthandize kuchuluka kwa shuga m'magazi, poganizira momwe alili. Regimen ya insulin imapangidwanso payekhapayekha. Itha kutumikiridwa 2 mpaka 6 pa tsiku.

Mulingo woyenera kwambiri ndi kuyambitsa insulin kanayi pa tsiku. Izi zimakuthandizani kuti muchepetse zovuta komanso kuwonongeka kwakukuru muumoyo wa wodwalayo. Potere, njira zingapo zoyendetsera mankhwalawa zimagwiritsidwa ntchito. Pakati pawo, omwe ali ambiri ndi:

• Syringe. Ino si syringe wamba, yomwe imagwiritsidwa ntchito jekeseni wamitsempha. Ili ndi singano yaying'ono komanso ndodo yopyapyala, kuti majekesedwewo asakhale opweteka komanso osavuta kukhazikitsa. Amawonetsedwa m'malo osiyanasiyana amthupi - m'chiuno, mapewa, pamimba, matako, ndi zina zambiri. Koma pazochitika zonse, lamulo limodzi lalikulu liyenera kuonedwa - kukhazikitsidwa kwa mankhwalawa kuyenera kuchitika mosaneneka, osatinyoza.
• Cholembera. Njira yabwino kwambiri yothandizira jakisoni. Syringe yotereyi imakhala ndi mtundu wina wapadera womwe umakhala wofunikira kumwa mankhwala. Mitundu ina ya ma syringe pensulo imakhala ndi makatoni ndi chida chomwe chimayendetsa kayendedwe ka mankhwala. Ngakhale ana amatha kugwira chida chotere.
• Pampu Chida china chosavuta komanso chaching'ono chomwe mumatha kunyamula nanu nthawi zonse. Kukhazikitsa kwa mankhwalawa kumachitika nthawi zonse kudzera mu catheter, yomwe imayikidwa pamimba. Kachubu kakang'ono kamalumikizidwa ndi catheter momwe mankhwalawo amathandizira.

Cholembera

Zotsatira za jakisoni

Insulin ndi chinthu chomwe chimatenga gawo limodzi pafupifupi machitidwe onse a metabolic omwe amapezeka m'thupi. Imagwira ngati biocatalyst ndipo imapereka machulukitsidwe amaselo ndi minyewa yamthupi ndi glucose. Kuphatikiza apo, mankhwalawa amalimbikitsa kusintha kwa glucose kukhala glycogen m'chiwindi ndi minofu, popanda njira zambiri ndizosatheka.

Insulin imaperekanso kuchuluka kwachilengedwe kwa ma amino acid ndi ma ion, zomwe zimapangitsa kuti azigwiritsa ntchito maselo a thupi mwachangu. Kuphatikiza apo, timadzi timeneti timatulutsa gawo limodzi mu makulidwe a phosphorylators ofunikira kagayidwe ka shuga.

Glucose imapezeka m'maselo am'maselo, ndipo glucohexokinases ili mkati mwa maselo pawokha. Akayamba kulumikizana ndi insulin, kupezeka kwa nembanemba kwamaselo kumawonjezereka, chifukwa chomwe glucose imalowetsedwa bwino mu cytoplasm of cell. Komanso, ntchito yake yayikulu ndikulepheretsa zochitika za glucose-6-phosphatase, zomwe zimapangitsa glycogenolysis.

Makina ochitira insulin ndi ovuta, siwosavuta kumvetsetsa kwa munthu yemwe ali kutali ndi sayansi ndi mankhwala. Koma ziyenera kudziwika kuti popanda iwo, zowonadi, machitidwe ambiri mthupi sangachitike. Ndipo kukana kwa insulini kuchepa kapena kuleka kupangika m'thupi, thupi limasiya kudya glucose, zomwe zimapangitsa kuti shuga awonjezeke. Ndipo izi zimaphatikizanso kuwonekera kwa zizindikirozi:

• kukodza pafupipafupi komanso kuwonjezeka kwa mkodzo tsiku ndi tsiku wokwanira malita 6 mpaka 10;
• kuchuluka kwa kuthamanga kwa shuga kwa magazi mpaka 6,7 ​​mmol / l ndi kupitilira;
• glucosuria (mpaka 10-12%);
• kutsika kwa milingo ya glycogen mu minofu minofu ndi chiwindi;
• kuphwanya mapuloteni kagayidwe;
• lipidemia, yomwe imadziwika ndi kuwonjezeka kwamafuta am'mwazi chifukwa cha njira ya oxidation yolakwika;
• kuchuluka kwa kuchuluka kwa matupi a ketone m'magazi (acitosis).

Zizindikiro zokhala ndi matenda ashuga

Ndi kusowa kwa insulin mthupi, otsutsana nawo omwe ali ndi vuto lina amaphatikizidwa ndi ntchitoyi. Izi zimangowonjezera kuchuluka kwa shuga m'magazi, komanso ma amino acid, komanso mafuta aulere acids. Chifukwa cha izi, wodwalayo amayamba kupanga matenda monga arteriosulinosis ndi angiopathy.

Insulin ikatulutsidwa m'maselo a kapamba, imalowa m'maselo a cell. Ikalowa mkatikati mwa iwo, imayamba kugwira ntchito yake, yomwe imalimbikitsidwa kuyendetsa shuga komanso kugwiritsa ntchito mafuta.

Monga tafotokozera pamwambapa, kapangidwe ka glycogen, yemwe amalepheretsa kusintha kwa amino acid kukhala glucose, zimatengera kapangidwe ka insulin. Pachifukwa ichi, madokotala amalimbikitsa jekeseni wa insulin atangotha ​​kugwira ntchito zolimbitsa thupi, chifukwa izi zimakhudza kukula kwa minofu.

3.3-5.5 mmol / L amadziwika kuti ndi zodziwika bwino za shuga m'magazi. Ngati manambala ndi otsika, ndiye kuti tikulankhula za hypoglycemia, ngati apamwamba - hyperglycemia. Chodabwitsa, momwe zimawonekera, zochitika za hypoglycemic zimadziwikanso ndi odwala matenda ashuga. Amayamba pazifukwa zosiyanasiyana - jakisoni wosadziwika kapena kuchita masewera olimbitsa thupi mopitirira muyeso.

Mwazi wamagazi

Koma onsewa a hypoglycemia ndi hyperglycemia ndi oopsa kwambiri, chifukwa amatha kuchititsa munthu kuti akhale ndi vuto laukadaulo, momwe ma cell a ubongo amayamba kufa ndi njala. Ndi kuchepa kwa oksijeni, zimawonongeka, zomwe zimakhudza osati magwiridwe antchito a ubongo, komanso machitidwe a ziwalo zonse.

Tiyenera kudziwa kuti kuchuluka kwa shuga m'magazi kumatha kuwonjezera osati odwala matenda ashuga motsutsana ndi kusakwanira katemera wa insulin, komanso mwa anthu athanzi kwathunthu. Izi zimachitika, monga lamulo, mutadya chakudya. Mafuta ochulukirapo pamilandu iyi amatha kuwonedwa kwa maola angapo, koma ndiye kuti mulingowo ungafanane. Izi zikachitika patapita nthawi ndipo zimawonedwa pafupipafupi, ndiye chifukwa chachikulu kukaona dokotala ndikupereka mayeso onse ofunikira a shuga. Kumbukirani kuti akapezeka msanga, ndiye kuti mungamulepheretse zovuta zake kuti zisakule.