Mitundu ya mankhwala a insulin a shuga

Nthawi yovuta imabwera chifukwa cha thupi, maselo a β-maselo atasiya kupanga kuchuluka kwa insulin kwa thupi, ndipo osati chifukwa choti ndi aulesi, koma chifukwa cha matenda sangathenso.

Kenako m'miyoyo yokhala ndi utoto wonyezimira, waimvi, wamvula ikayamba kupambananso.

Munthawi imeneyi kuti apulumutse, achiwongola insulin - kuwala kwa dzuwa, chisangalalo ndi chiyembekezo. Ndipo chilichonse chozungulira chikusinthidwa, kumadzazidwa ndi mpweya wabwino wamoyo.

Inde, abwenzi, ndi mankhwala a insulin, limodzi ndi mankhwala ena, omwe angakubwezeretseni kumvetsetsa - moyo umapitilizabe.

Mitundu ya Insulin Therapy

Zochizira m'chinenedwe chakale cha Greek zimveka ngati chithandizo, chisamaliro chamankhwala. Pakaliponsepa m'dzina lake tanthauzo la njirayi. Mankhwala a insulin ndi mankhwala a insulin, ndiye kuti, ndi magawo omwe cholinga chake ndicho kulipiritsa kusalingana komwe kwayamba mu metabolic (metabolic) pobweretsa insulin m'thupi.

Njirayi imagawidwa m'mitundu ingapo:

Chachikhalidwe kapena Kuphatikiza. Njira yakuchizira imaphatikizira jakisoni munthawi yomweyo m'thupi la mankhwala osiyanasiyana osakhalitsa: yayifupi, yapakati, yayitali.

Ubwino:

1. Cholinga cha wodwalayo pofuna kulandira chithandizo.
2. Kuchepetsa jakisoni. Njira ychithandizochi imatha kupezeka mosavuta ndi wodwalayo komanso abale ake kapena antchito osamalira.
3. Palibe chifukwa chowunikira mosalekeza glycemia (shuga wamagazi).
4. Pafupipafupi tsiku lililonse jakisoni amachepetsa.
5. Kuchotsa msanga kwa poyizoni wa shuga.

Zoyipa:

• Kutsatira mosafunikira zakudya, mogwirizana ndi mlingo wosankhidwa wa mankhwalawo;
• kuchuluka kwa chakudya kuyenera kukhala kosachepera 5-6 patsiku, ndi njira zofanana nthawi;
• kulephera kutengera mlingo womwe umaperekedwa m'magazi;
• hyperinsulinemia, yomwe imayendera limodzi ndi njira zonse zophatikizira mankhwala, imatha kupangitsa matenda a atherosulinosis, matenda oopsa, komanso kuchepa kwakukulu kwa mayoni a potaziyamu m'magazi.

Chithandizo cha pampu. Ndi njira iyi, wodwalayo amalumikizidwa ku chipangizo chamagetsi chopangidwa ndi kubayidwa kwa jekeseni lozungulira la wotchiyo. Pa nthawi yofotokozedwa mosamala, wodwalayo ayenera kupatsidwa mlingo wochepa wa mankhwala a ultrashort komanso yochepa.

Ubwino:

• pampu, kudyetsa yankho mu mphindi zochepa, kumatsimikizira kulondola ndi kupitiliza kwa kayendetsedwe;
• mwayi wogwiritsa ntchito mankhwala amfupi ndi a ultrashort;
• pulogalamu yama pampu yamagetsi imatha kuganizira zosowa za thupi nthawi zambiri: kudya, kugona, kugona;
• Njirayi imathetsa kuwunikira kwakanthawi kochepa ndi kumwa kwa mankhwalawo.

Zoyipa:

• kulephera kwa pampu kusinthiratu magwiridwe antchito a kapamba;
• kufunika kosintha khungu lanu nthawi zonse;
• pakuwongolera pulogalamu, glucose miyeso iyenera kumwedwa kamodzi pa tsiku.

Chithandizo cholimbitsa. Limagwirira ntchito njirayi ili pakulimbikitsa kutsata njira zomwe zimachitika pobisalira insulin.

Kuti maziko a bolus insulin (azikulitsidwa) kuti akwaniritse ntchito zake, ndikofunikira kupereka zinthu zingapo:

1. Panthawi inayake, mankhwala omwe aperekedwa ndi mankhwalawa amayenera kufananizana ndi zosowa za thupi zogwiritsira ntchito shuga wolandiridwa.
2. Hormoni yomwe idalowetsedwa mthupi imayenera kubwereza basal kapena kusiyanasiyana, i.e., secretion yokhala ngati ma cell a beta.
3. Mlingo womwe umaperekedwa uyenera kubwereza njira zonse zapamwamba zomwe zimachitika m'mimba pakudya.

Ubwino:

• kutengera kwakukulu kwa zochita zathupi;
• kusiyanasiyana kwa kagayidwe kachakudya njira, yomwe imatha kuthana ndi zovuta zingapo;
• nyimbo ya wodwalayo imapeza zolimbikitsira zabwino, zomwe sizimangowoneka mu chakudya chaulere chokha.

Zoyipa:

1. Maphunziro apamwamba kwambiri munjira imeneyi. Kufunika kopita ku masukulu a matenda ashuga, komwe kumachitika kafukufuku wazinthu zingapo zomwe zimachitika mthupi.
2. Kufunika kowonetsetsa mwachangu ma glucose osakanikirana ndi maulendo 7 pa tsiku.
3. Ndi kuchepa kwa kayendetsedwe ka shuga m'thupi, pamakhala chiwopsezo chachikulu cha hypoglycemia - kutsika kwa shuga m'munsi mwabwinobwino.

Kuphatikiza apo mankhwalawa omwe amaperekedwa amasiyana pakadutsa kachitidwe, imakhudzanso modutsa tsiku ndi tsiku lomwe limakhudzana ndi zakudya, kugona komanso kugona.

Kuti mumvetsetse momwe metabolic amapangira thupi, ndikofunikira kuti muphunzire matanthauzidwe ena okhudzana ndi mahomoni awa:

1. Bolus insulin - uyu ndiye othandizira omwe amalimbikitsa kuyamwa kwa chakudya chamagulu m'zakudya. Nthawi zambiri amadyedwa chakudya.
2. Basal insulin - imakhala yotupa kwa nthawi yayitali, yosasintha kapena, monga amatchedwanso, timadzi tambiri tambiri tomwe timafunikira thupi lonse tsiku lonse. Mwa njira, kapamba wake amatulutsa mosalekeza kwa maola 24.

Zolemba mu shuga kwa ana

Ndikoyenera kuyambitsa gawo ili ndi chochititsa chidwi kwambiri. Kwa nthawi yoyamba, insulin idaperekedwa kwa anthu pa Januware 11, 1922. Anali mwana - mwana wazaka 14. Jakisoni adapangidwa ndi wasayansi waku Canada Frederick Bunting.

Koma pancake yoyamba, monga momwe amayembekezera muzochitika zoterezi, zidadzaza. Chifukwa choti kukonzekera sikunayeretsedwe mokwanira, kuyesa koyamba kudadziwika ndi kulephera - mwana adayamba kudwala.

Kwa masabata awiri, katswiri wazamankhwala James Collip wakhala akupanga njira yoyeretsera mankhwalawa. Zitatha izi, pa Januware 23, jakisoni wachiwiri adaperekedwa kwa mwana wodwala - zotsatira zake zinali zabwino. Sikuti mwana adalibe zotsatira zoyipa zilizonse - matendawo omwe adachepa, panali kuwongolera kowonekera bwino pakupanga shuga.

Chifukwa cha zomwe anapeza, wasayansiyo ndi mnzake adalandira Mphoto ya Nobel.

Kuyambira pamenepo, mankhwalawa adayamba kuthandiza osati ana okha, koma, zoona, achikulire.

Komabe, ndikofunikira kudziwa kuti chithandizo choterechi chili ndi mbali zingapo zaunyamata, ndikofunikanso kusiyanitsa magawo amtundu wa odwala ochepa.

Chimodzi mwazinthu izi ndi kuphatikiza kwa mankhwalawa omwe amakhala ndi nthawi yosiyanasiyana yogwira ntchito. Izi ndizofunikira kuti muchepetse kuchuluka kwa njira za tsiku ndi tsiku.

Nthawi yomweyo, kusankha mitundu yosiyanasiyana ya zida zochizira mwana yemwe akudwala matenda a "shuga", mankhwalawa amakonda 2 ndi 3-3-kukhazikitsa mahomoni masana.

Kuphatikiza apo, zinaonedwa kuti mankhwala othandizira insulin ndi othandiza kwambiri ngati amaperekedwa kwa ana azaka zopitilira 12.

Hormone chithandizo mwa amayi apakati

Hormone chithandizo kwa amayi apakati omwe ali ndi matenda ashuga ali ndi zolinga ziwiri zofanana:

• kutsika kwa shuga m'magazi mpaka pamlingaliro wolimbikitsidwa;
• kupulumutsa moyo wa mwana wosabadwa.

Mchitidwewu mu amayi apakati umakhala wovuta kwambiri: zochitika zolimbitsa thupi zomwe zimachitika panthawiyi mthupi la mkazi ndizosakhazikika.

Nthawi iliyonse izi ziyenera kukumbukiridwa popereka chithandizo chamankhwala chimodzi, komanso mlingo wa mankhwalawo.

Endocrinologists amalimbikitsa kuti, pamimba yopanda kanthu, shuga m'magazi amtsogolo mwa mwana sayenera kupitirira 3,3-5.6 mmol / L., Ndipo atatha kudya, mtengo wake unali pamlingo kuchokera pa 5.6 mpaka 7.2 mmol / L.

Njira zomwe zimalimbikitsidwa tsiku ndi tsiku ndi ma jakisoni awiri. Pankhaniyi, mankhwala osokoneza bongo osakhalitsa angathe kuperekedwa nthawi yomweyo.

Monga lamulo, m'mawa musanadye chakudya cham'mawa, mayi woyembekezerayo ali ndi jakisoni wa 2/3 wa tsiku ndi tsiku, ndipo asanadye chakudya chamadzulo, 1/3 yotsalira ya mahomoni.

Nthawi zina madokotala amatipatsa jakisoni asanagone, m'malo mwa njira yamadzulo. Izi ndikuti tilewe kuchuluka kowonjezereka kwa shuga m'magazi apakati m'mawa.

Kanema kuchokera kwa katswiri:

Mankhwala othandizira odwala matenda amisala

Sizowoneka zodabwitsa kwa owerenga kuti mahomoni omwe ali pamwambawa sagwiritsidwa ntchito pokhapokha polimbana ndi matenda a shuga, komanso mankhwalawa amitundu yoipa yamatenda amisala, koma izi ndi zowona.

Njira imeneyi imagwiritsidwa ntchito pochiza odwala matenda a schizophrenia.

Woyambitsa njirayi, dokotala wazamisala waku America waku Austria, Manfred Sackel, mu 1935, adati zimakupatsani mwayi kuti mubwererenso moyo wabwino 80% ya anthu odwala ndimaganizo.

Chithandizo chikuchitika mu magawo atatu:

1. Pamagawo oyamba (oyamba), wodwalayo amamizidwa munthawi yomwe kuchuluka kwa glucose m'magazi kumachepetsedwa kwambiri. Kenako, pogwiritsa ntchito tiyi wokoma kwambiri, shuga imabwezedwa pamtengo wake wabwinobwino.
2. Gawo lachiwiri. Amadziwika ndi kuyambitsa mlingo waukulu wa insulin, chifukwa chake wodwalayo amizidwa mu khungu losazindikira, lomwe limatchedwa stupor. Atapezanso mphamvu, amamwetsanso ndi madzi a shuga.
3. Pa gawo lachitatu, wodwala wamisala amaphatikizidwanso ndi mahomoni omwe amapitilira zomwe zimachitika tsiku ndi tsiku, amamuyika iye pamalire pamalire pakati pa chikomokere ndi stupor. Gawoli limatenga pafupifupi mphindi 30. Kenako hypoglycemia imachotsedwa monga tafotokozera pamwambapa.

Kutalika kwa chithandizo kuli mpaka magawo makumi atatu, pomwe munthawiyo nkhawa za m'maganizo zimakhazikika ndipo wodwalayo amamva bwino.

Komabe, ziyenera kudziwika kuti kugwira ntchito kwa njirayi kumayikiridwa ndipo kumakhala ndi otsutsa ambiri.

Zizindikiro za

Wowerengayo mosakayikira ali ndi chidwi chofuna kudziwa: kodi shuga amapatsidwa shuga uti?

Zochita zachipatala zimawonetsa kuti wodwalayo "amakhala pansi" pamankhwala awa, monga lamulo, zaka zisanu atazindikira matendawa. Komanso, wodziwa za endocrinologist nthawi zonse amatha kukuwuzani nthawi yomwe amasintha kuchokera ku mapiritsi kuti ajekeseni.

Ndiye ndizomveka kuti owerenga osasinthaku afunsa funso lotsatirali: chifukwa pambuyo pa zonse, ndibwino, mapiritsi kapena insulin?

Yankho lake ndilosavuta - zonse zimatengera gawo la matendawo, kapena ndikosavuta kunena kuti matendawa apezeka liti.

Ngati kuchuluka kwa shuga m'magazi sikupitirira 8-10 mmol / l, ndiye kuti izi zikuwonetsa kuti mphamvu za β-cell za kapamba sizinathe, koma amafunikira thandizo la mapiritsi. Ndi shuga ena okwera, insulin imayikidwa. Izi zikutanthauza kuti ngati manambala apitilira chizindikiro cha 10 mmol / l, ndiye kuti chithandizo chomwe chatchulidwa pamwambapa sichingagawidwe nawo. Ndipo zitha kukhala kwa nthawi yayitali, ngati sichoncho kwa moyo.

Ngakhale pali milandu yambiri pamene maselo opuma a beta ayambanso kugwira ntchito moyenera ndipo adokotala, mosangalatsa wodwalayo, amaletsa kuikidwa kwa mtundu uwu wa mankhwalawa.

Kugwiritsa ntchito mahomoni ngati chithandizo sikufuna maluso apadera komanso chidziwitso, chifukwa chake, tikulimbikitsidwa kuti odwala omwe ali ndi matenda amtundu wa 1 kapena mtundu wa 2 ayambe jekeseni wa insulin.

Komabe, malamulo ena a insulin mankhwala amafunikabe kudziwa ndikutsatira mwaluso.

Izi zikuphatikiza:

1. Kuti muchepetse nthawi yoyambira yomwe mankhwalawa ayamba, gwiritsani ntchito bwino ndikusintha khungu lanu komwe kubayidwa.
2. Kudya pambuyo pakupuma kwa mphindi makumi atatu pambuyo poti jekeseni yoletsedwa - sipangakhale zotsatira.
3. Mlingo wa tsiku lililonse wa mankhwalawa omwe waperekedwa sayenera kupitirira 30 magawo.
4. Tsatirani mosamalitsa chithandizo chamankhwala chokhacho chomwe dokotala wakupatsani.

Kwa jakisoni, ma syringes apadera ndi zolembera zama syringe zimagwiritsidwa ntchito, zomwe ndizodziwika bwino.

Ubwino wa cholembera:

1. Singano yapadera yomwe imabwera ndi chida chachipatalachi imachepetsa ululu.
2. Kugwiritsa ntchito mayendedwe ndi kugwiritsa ntchito.
3. Kuthekera kotsatira njirayi sikumadziwika ndi malo kapena nthawi.
4. Mapensulo ena a syringe ali ndi zida zomwe zimakupatsani mwayi wophatikiza mitundu yosiyanasiyana ya mitundu ya mitundu, kusintha mitundu ndi mitundu ya mankhwala.

Malankhulidwe atangofika pa algorithm yamankhwala, pakumvetsetsa kwakukulu kumakhala ndi mawonekedwe otsatirawa:

1. Asanadye chakudya cham'mawa - kukhazikitsidwa kwa hormone yochepa kapena yayitali.
2. Tisanadye chakudya chamadzulo, koma osati kale kuposa mphindi makumi atatu, mankhwala omwe amakhala ndi nthawi yochepa yowonetsedwa amagwiritsidwa ntchito.
3. Madzulo a chakudya chamadzulo - kukhazikitsidwa kwa mlingo "wamfupi".
4. Asanagone, wovutikayo amapatsidwa mankhwala "omwe amakhala" kwakanthawi - mankhwala omwe amakhala nthawi yayitali.

Maphunziro a kanema wa syringe-cholembera insulin

Zotheka

Moyo ndi machitidwe azachipatala awonetsa kuti kukhazikika kwamtundu wa 2 shuga mellitus, ndikofunikira kumwa insulin, pomwe simukuyenera kuopa zovuta.

Pogwiritsa ntchito mankhwalawa, kuwonetsa zizindikilo za zovuta za ambiri odwala sizinapezeke. Ngakhale mwachilungamo ndikofunikira kudziwa kuti pali zotsatira zakumaloko zomwe zimakhudzana ndi mawonekedwe a anthu.

Madokotala akuphatikizapo:

1. Thupi lawo siligwirizana. Imawonetsedwa ndi kuyabwa kapena kuzungulira pamalo a jekeseni. Izi zitha kuchitika chifukwa cha kuwonongeka kwa dera la pakhungu (kakulidwe kenakake kapena kakulidwe), komwe kamakhala jekeseni losasamba kapena jakisoni wosazizira.
2. Hypoglycemic state (shuga yotsika kwambiri kuposa masiku onse). Izi zikuwonetsedwa ndi kuchuluka kwa thukuta, thukuta, kunjenjemera (kuthina) kwa zala kapena miyendo. Chomwe chimapangitsa izi kukhala kuchuluka kwa insulini, kuphwanya pulogalamu ya nthawi ya chithandizo, manjenje amanjenje kapena kusangalala. Thandizo loyamba: idyani magalamu 100 a mabulosi kapena zidutswa zinayi za shuga, kapena imwani kapu ya tiyi wokoma.
3. Insulin lipodystrophy. Izi ndi zotsatira zakukhazikika kwa mankhwalawa pamalo omwewo, kukonzekera kozizira kapena malo osapsa. Zizindikiro zowoneka ndikusintha kwa khungu ndi kuchepa kwamafuta amkati.

Chithandizo cha insulin ndi chithandizo chodziwika bwino padziko lonse cha matenda a shuga. Kugwiritsa ntchito mwaluso komanso movutikira, komwe kumayang'aniridwa ndi katswiri wazogwiritsa ntchito endocrinologist, kumatha kuyendetsa bwino wodwalayo ndikumubwezeretsanso malingaliro amoyo.