AMA-INSULIN THERAPY REGIMENS

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Kunama-regimens ambalwa we-insulin ezigulini ezinesifo sikashukela. Uhlelo ngalunye lubonakala ngenqubo yalo kanye nenani lansuku zonke lomthamo ophathwe i-insulin. Ngokuphathelene nobuntu bomzimba, umsebenzi ohlukile womzimba, ukudla okuthathwa yisifo sikashukela, kuthathwa isilinganiso somuthi ngamunye, sibalwa ngokuya ngesikimu esisodwa noma esinye.

Ngokwe-theoretically, kunzima kakhulu ukubala inani elidingekayo le-insulin - umthamo ofanayo olawulwa yiziguli ezahlukahlukene ungadala ukusabela okuhlukile komzimba, ngenxa yokusebenza komuthi, isikhathi nobude besenzo sawo. Ukubalwa kwenani le-insulin kwenziwa esibhedlela, lowo onesifo sikashukela unquma inani lelo, alihambise ngamandla omzimba, athathe ukudla noshukela egazini.

Izinhlobo zama-insulin zokuphatha

Phakathi kwezinhlelo ezikhona zokwelashwa kwe-insulin, kunezinhlobo ezi-5 eziphambili:

Umjovo owodwa we-insulin osebenza isikhathi eside noma ophakathi nendawo;
Ukujova kabili kwe-insulin yangaphakathi;
Ukujova kabili kwe-insulin esezingeni eliphakathi nendawo nelifushane;
Kathathu umjovo we-insulin omfushane futhi owenziwe isikhathi eside;
Isisekelo uhlelo lwe-bolus.

Inqubo yokuzitholela kwemvelo okwenziwa nsuku zonke kwe-insulin ingamelwa ngesimo somugqa onama-vertices ngezikhathi zekhonkco le-insulin elenza ihora elilodwa ngemuva kokudla (Umfanekiso 1). Isibonelo, uma umuntu ethatha ukudla ngo-7 a.m., 12 p.m., 6 p.m. no-10 p.m. khona-ke isilinganiso se-insulin sizokwenzeka ngo-8 a.m., 1 p.m. 7 p.m no 11 p.m.

Ijika lamasango emvelo linezigaba eziqondile, ukuxhuma esithola isisekelo - umugqa. Izingxenye eziqondile zihambelana nezikhathi lapho umuntu ongenaso isifo sikashukela engadli futhi i-insulin ikhishwa kancane. Ngesikhathi sokukhishwa kwe-insulin ngemuva kokudla, umugqa oqondile wokuqothuka kwemvelo uhlukaniswe iziqongo zezintaba ngokukhuphuka okukhulu kanye nokwehla okungatheni.

Umugqa onezihloko ezine ukhetho "oluhle", oluhambelana nokukhululwa kwe-insulin ngokudla okungu-4 ngosuku ngesikhathi esichazwe ngokuqinile.

Eqinisweni, umuntu ophile kahle angahambisa isikhathi sokudla, weqa isidlo sasemini noma isidlo sakusihlwa, ahlanganise isidlo sasemini namalantshi noma athathe ukudla okulula, kulokhu kuvela iziqongo ezincanyana ze-insulin esibondweni.

Umjovo owodwa we-insulin osebenza isikhathi eside noma ophakathi nendawo

Umjovo owodwa ubangelwa ukwethulwa komthamo we-insulin nsuku zonke ekuseni ngaphambi kokudla kwasekuseni.

Isenzo salesi sikimu ijika eliqhamuka ngesikhathi sokuphatha umuthi, lifinyelela inani eliphakeme ngesikhathi sasemini futhi lehlela phansi kuzodla isidlo sakusihlwa (igrafu 2)

Isikimu singesinye esilula, sinezinkinga eziningi:

Ijika elilodwa-elilodwa-mancane amathuba okuba lifane nejika lemvelo lokufihlwa kwe-insulin.
Ukusetshenziswa kwalolu hlelo kufaka phakathi ukudla izikhathi eziningana ngosuku - isidlo sasekuseni esikhanyayo sithathelwa indawo isidlo sasemini esiningi, isidlo sasemini esiningi nokudla okuncane.
Inani nokwakheka kokudla kufanele kuhambisane nokusebenza kwesenzo se-insulin okwamanje kanye nezinga lomsebenzi womzimba.

Okubi kwesikimu kufaka amaphesenti aphezulu wobungozi be-hypoglycemia, imini nobusuku. Ukuvela kwe-noogurnal hypoglycemia, ephelezelwa umthamo owengeziwe we-insulin yasekuseni, kwandisa ingozi ye-hypoglycemia ngaleso sikhathi sokusebenza kahle kakhulu komuthi

Ukwethulwa komthamo obalulekile we-insulin kuphazamisa umzimba we-metabolism, okungaholela ekwakhekeni kwezifo ezihlangene.

Lolu hlelo alunconywa kubantu abanesifo sikashukela sohlobo 1, uhlobo 2 sikashukela, ukwelashwa kusetshenziswa ngokubambisana nezidakamizwa ezinciphisa ushukela ezethulwa ngesikhathi sokudla.

Ukujova kabili kwesenzo sangaphakathi se-insulin

Lolu hlelo lokwelashwa kwe-insulin lubangelwa ukwethulwa kwezidakamizwa ekuseni ngaphambi kokudla kwasekuseni nakusihlwa ngaphambi kokudla kwakusihlwa. Umthamo wansuku zonke we-insulin uhlukaniswe ekuseni nakusihlwa ngesilinganiso se-2: 1, ngokulandelana (igrafu 3).

Izinzuzo zesikimu ukuthi ubungozi be-hypoglycemia buncishisiwe, kanti ukwahlukaniswa kwe-insulin emithanjeni emibili kunomthelela kumthamo ophansi ojikelezayo emzimbeni womuntu.
Okubi kwecebo kufaka okunamathiselwe okuqinile kwirejimeni nasekudla - umuntu onesifo sikashukela kufanele adle ngaphansi kwezikhathi ezi-6 ngosuku. Ngaphezu kwalokho, ijika lesenzo se-insulin, njengasesikhathini sokuqala, likude kakhulu nejika lemvelo le-insulin secretion.

Ukujova kabili kwe-insulin esezingeni eliphakathi nendawo nefish

Enye yezinhlelo ezisezingeni eliphezulu ibhekwa njengomjovo ophindwe kabili we-insulin ophakathi nendawo futhi omfushane.

Lolu hlelo lubonakala ngokufakwa kwezidakamizwa ekuseni nakusihlwa, kepha ngokungafani nohlelo lwangaphambilini, luyakwazi ukuguqula umthamo we-insulin nsuku zonke ngokuya ngomzimba oluzayo noma umthamo wokudla.

Esikhathini sikashukela, ngenxa yokuqhathaniswa komthamo we-insulin, kungenzeka ukuthi kuguqulwe imenyu yesifo sikashukela ngokusebenzisa umkhiqizo onokuqukethwe okunoshukela omningi noma ukwandisa inani lokudla okuthathiwe (ishadi 4).

Uma phakathi nosuku ohlela ngalo isidlo esisebenzayo (ukuhamba, ukuhlanza, ukulungisa), umthamo wasekuseni we-insulin omfushane unyuka ngamayunithi ama-2, futhi umthamo ophakathi nendawo uyancipha ngamayunithi ama-4 - 6, njengoba ukusebenza komzimba kuzoba nomthelela ekwehliseni ushukela;
Uma umcimbi ohlonishwayo ngokudla okuningana kuhlelelwa kusihlwa, umthamo we-insulin omfushane kufanele ukhuphuke ngamayunithi ama-4, ophakathi nendawo - ushiye ngokulinganayo.

Ngenxa yokwehlukaniswa okunengqondo komthamo wansuku zonke wezidakamizwa, ijika lokujova okulingene kwe-insulin esezingeni eliphakathi nendawo nelifushane kakhulu lisondele ekugqondweni kokugodlwa kwemvelo, okulenza libe likhulu kakhulu futhi lilungele ukwelashwa kwesifo sikashukela sohlobo 1. Inani le-insulin lifakwe lizungeza ngokulingana egazini, okunciphisa ingozi ye-hypoglycemia.

Ngaphandle kwezinzuzo, uhlelo alunazo izithiyo, olunye lwazo oluhambisana nokudla okunzima. Uma ukwelashwa kwe-insulin okuphindwe kabili kukuvumela ukuthi uguqule uhla lokudla, khona-ke ukuphambuka ohlelweni lokudla okunqatshelwe akuvunyelwe ngokuphelele. Ukuphambuka ohlelweni lwesigamu sehora kusongela ngokuvela kwe-hypoglycemia.

Kathathu umjovo we-insulin emfushane nehlala isikhathi eside

Ukujova okwenziwa kathathu kwe-insulin ekuseni nantambama kuhambelana nohlelo lwangaphambilini lokwelashwa okuphindwe kabili, kepha kuguquguquka ngokwengeziwe kusihlwa, olwenza kube ngcono. Uhlobo lolo lubandakanya ukuphathwa kwengxube ye-insulin efushane nehlala isikhathi eside ngaphambi kokudla kwasekuseni, imithamo ye-insulin emfushane ngaphambi kwasemini kanye nedosi elincane le-insulin ende ngaphambi kokudla kwakusihlwa (Umfanekiso 5).

Uhlelo luvumelana nezimo ngokwengeziwe, ngoba luvumela ukuguqulwa kwesikhathi sokudla kwakusihlwa kanye nokwehla komthamo we-insulin ende. Ijika lomjovo obuphindwe kathathu lusondele kakhulu endaweni yokuqunjelwa kwemvelo ye-insulin kusihlwa.

Isisekelo - Isikimu seBolus

Isisekelo - irejimeni le-bolus ye-insulin Therapy noma enye ethembisa kakhulu, ngoba isondele kakhulu ekujikeni kokuvikelwa kwe-insulin yemvelo.

Ngohlobo lwasisekelo-bolus lokuphathwa kwe-insulin, uhhafu wethamo eliphelele liwela kwi-insulin esebenza isikhathi eside, nengxenye kwenye "emfishane". Izingxenye ezimbili kwezintathu ze-insulin isikhathi eside ziphathwa ekuseni nantambama, ezinye ziphumule kusihlwa. Umthamo we-insulin "omfishane" kuncike kunani kanye nokwakheka kokudla okuthathiwe.