Ma insulin omwe amakhala kwa nthawi yayitali amagwiritsidwa ntchito kuti azikhala ndi mahomoni ambiri amtundu 1 komanso matenda amitundu iwiri. Mankhwalawa akuphatikizapo Tresiba yopangidwa ndi Novo Nordisk.
Tresiba ndi mankhwala ozikidwa ndi mahomoni ofanana kwambiri.
Ndi analogue yatsopano ya basal insulin. Imaperekanso chiwonetsero chofananira cha glycemic ndi chiopsezo chocheperako cha usiku.
Makhalidwe ndi pharmacological zochita
Zina mwa mankhwalawa zimaphatikizapo:
- kutsika kosakhazikika komanso kosalala kwa shuga;
- kuchita zoposa maola 42;
- kusinthasintha kochepa;
- kuchepetsa shuga;
- mbiri yabwino yachitetezo;
- kuthekera kwa kusintha pang'ono panthawi ya insulin popanda kusiya thanzi.
Mankhwalawa amapangidwa ngati ma cartridges - "Tresiba Penfil" ndi ma syringe-pens omwe ma cartridge amatsekedwa - "Tresiba Flexstach". Chosakaniza chophatikizacho ndi insulin Degludec.
Degludec imamanga pambuyo povomerezedwa ndi maselo amafuta ndi minofu. Pali kulowetsa pang'onopang'ono komanso mosalekeza kulowa m'magazi. Zotsatira zake, kutsika kwamphamvu kwa glucose kumapangidwa.
Mankhwalawa amalimbikitsa kuyamwa kwa glucose ndi minyewa komanso kuletsa kwake kutulutsa kwa chiwindi. Ndi kuchuluka kwa mlingo, kutsitsa kwa shuga kumawonjezeka.
Kuphatikizika kwa mahomoni ofanana kumapangidwa pafupifupi pakatha masiku awiri ogwiritsira ntchito. Kufunikira kwazinthu kumatha maola opitilira 42. Kutha theka moyo kumachitika mu tsiku.
Zisonyezero zogwiritsidwa ntchito: mtundu 1 ndi 2 shuga mwa akulu, matenda a shuga kwa ana 1 chaka.
Kutsutsana kutenga Tresib insulin: ziwengo kwa mankhwala zigawo zikuluzikulu, Degludek tsankho.
Malangizo ogwiritsira ntchito
Mankhwalawa amaperekedwa nthawi yomweyo. Kulandila kumachitika kamodzi patsiku. Odwala omwe ali ndi matenda amtundu wa 1 amagwiritsa ntchito Degludec kuphatikiza ndi insulin yochepa kuti isafunike pakudya.
Odwala omwe ali ndi matenda ashuga amatenga mankhwalawo mosatengera chithandizo chowonjezera. Tresiba imayendetsedwa padera komanso mophatikizana ndi mankhwala oikidwa ndi mapiritsi kapena insulin ina. Ngakhale kusinthasintha posankha nthawi yoyang'anira, nthawi yocheperako iyenera kukhala osachepera maola 8.
Mlingo wa insulin umakhazikitsidwa ndi adokotala. Amawerengeredwa potengera zosowa za wodwala mu timadzi tating'onoting'ono pakayankhe glycemic. Mlingo woyenera ndi magawo 10. Ndi kusintha kwa zakudya, katundu, kukonza kwake kumachitika. Ngati wodwala wodwala matenda a shuga 1 amatenga insulin kawiri pa tsiku, kuchuluka kwa insulini komwe kumayendetsedwa kumatsimikiziridwa payekhapayekha.
Mukasinthira ku Tresib insulin, kuchuluka kwa shuga kumayendetsedwa kwambiri. Chidwi chachikulu chimaperekedwa kuzizindikiro mu sabata yoyamba kumasulira. Chiwerengero chimodzi kapena chimodzi kuchokera pa mulingo woyamba wamankhwala umayikidwa.
Tresiba imabayidwa pang'onopang'ono m'malo otsatirawa: ntchafu, phewa, khoma lakutsogolo kwam'mimba. Pofuna kupewa kukwiya komanso kuperewera, malowa amasintha mosamala m'deralo.
Sizoletsedwa kugwiritsira ntchito timadzi mwamkati. Izi zimakwiyitsa kwambiri hypoglycemia. Mankhwalawa sagwiritsidwa ntchito popukutira mapiritsi ndi kulowetsedwa. Kupusitsa komaliza kumatha kusintha kuchuluka kwa mayamwidwe.
Malangizo pavidiyo ogwiritsa ntchito cholembera:
Zotsatira zoyipa ndi bongo
Mwa zina zoyipa zomwe odwala atenga Tresiba adachita, ndi izi:
- hypoglycemia - nthawi zambiri;
- lipodystrophy;
- zotumphukira edema;
- thupi siligwirizana;
- zimachitika pa jakisoni malo;
- chitukuko cha retinopathy.
Mukamamwa mankhwalawa, hypoglycemia ya zovuta zosiyanasiyana imatha kuchitika. Njira zosiyanasiyana zimatengedwa kutengera mkhalidwe.
Ndi kuchepa pang'ono kwa glycemia, wodwalayo amamwa 20 g shuga kapena zinthu zomwe zili nazo. Ndikulimbikitsidwa kuti nthawi zonse mumanyamula shuga mulingo woyenera.
Woopsa, womwe umachitika limodzi ndi kuwonongeka kwa chikumbumtima, IM glucagon imayambitsidwa. Osasinthika, shuga amayamba. Wodwalayo amayang'aniridwa kwa maola angapo. Kuti athane ndi matenda obwereranso, wodwala amatenga chakudya chamagulu.
Odwala Apadera ndi Mayendedwe
Zomwe amamwa mankhwalawa pagulu lapadera la odwala:
- Tresiba amavomerezedwa kuti azigwiritsidwa ntchito ndi okalamba. Gulu ili la odwala liyenera kuwunika kuchuluka kwa shuga pafupipafupi.
- Palibe maphunziro pazotsatira za mankhwalawa panthawi yomwe ali ndi pakati. Ngati adaganiza kuti amwe mankhwalawo, ndikofunikira kuti kuwunikira kuwonetsa zizindikiro, makamaka mu 2nd ndi 3 trimester.
- Palibenso chidziwitso cha mankhwalawa panthawi ya mkaka wa mkaka. Mukudyetsa ana akhanda, zoyipa sizinawonedwe.
Mukamatenga, kuphatikiza kwa Degludek ndi mankhwala ena kumaganiziridwa.
Anabolic steroids, ACE inhibitors, sulfonamides, adrenergic blockers, salicylates, piritsi la kuchepetsa shuga la shuga, Mao inhibitors amachepetsa shuga.
Mankhwala omwe amachulukitsa kufunika kwa mahomoni amaphatikizapo sympathomimetics, glucocorticosteroids, Danazole.
Mowa umatha kusokoneza zochita za Degludek onse pakuwonjezera ndikuchepetsa ntchito yake. Ndi kuphatikiza kwa Tresib ndi Pioglitazone, kulephera kwa mtima, kutupa kungayambike. Odwala amayang'aniridwa ndi dokotala panthawi yamankhwala. Ngati mtima wasokonekera, mankhwalawa amasiya.
Mu matenda a chiwindi ndi impso pa mankhwalawa ndi insulin, munthu ayenera kusankha mankhwalawa. Odwala ayenera kuwongolera shuga pafupipafupi. Mu matenda opatsirana, dysfunctions ya chithokomiro, kupanikizika kwa mitsempha, kufunika kwa kusintha kwamphamvu kwa mlingo.
Mankhwala omwe ali ndi vuto lofananalo, koma ali ndi chinthu china chogwira ntchito, akuphatikizapo Aylar, Lantus, Tujeo (insulin Glargin) ndi Levemir (insulin Detemir).
Poyerekeza Tresib ndi mankhwala ofananawo, magwiridwe amodzi adatsimikiziridwa. Phunziroli, panali kuchuluka kwa shuga mu shuga, owonjezera ochepa obwera chifukwa cha usiku.
Umboni wa anthu odwala matenda ashuga umaperekanso umboni wa kutha kwa Treshiba. Anthu amadziwa kusintha kosavuta kwa mankhwalawo. Pakati pazovuta, mtengo wapamwamba wa Degludek umawunikidwa.
Ndakhala ndi matenda ashuga kwa zaka zoposa 10. Posachedwa ndidasinthira ku Tresibu - zotsatira zake zimakhala zabwino kwambiri kwanthawi yayitali. Mankhwalawa amachepetsa bwino komanso bwino kuposa Lantus ndi Levemir. Ndidzuka ndi shuga wabwinopo m'mawa wotsatira jekeseni. Sipanakhalepo usiku wa hypoglycemia. "Koma" ndiye mtengo wokwera. Ngati ndalama zilola, ndibwino kusinthana ndi mankhwalawa.
Oksana Stepanova, wazaka 38, St. Petersburg
Tresiba ndi mankhwala omwe amapereka basal secretion ya insulin. Ili ndi mbiri yotetezeka, imachepetsa shuga. Ndemanga za odwala zimatsimikizira kugwira ntchito kwake komanso kusasunthika. Mtengo wa Tresib insulin ndi pafupi ma ruble 6000.
