UKUHLUKANISWA KWE-INSULIN

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I-insulin yi-hormone yamanyikwe womuntu omsebenzi wakhe ukwehlisa nokulawula amazinga kashukela egazini.

Izifo ezahlukahlukene ze-metabolic ziholela ekungalingani kumazinga we-insulin nokungasebenzi kahle ekukhiqizweni kwawo okuvamile. Kulokhu, udokotela we-endocrinologist unquma izidakamizwa ezenzela ukuntuleka kwale hormone. Zonke izinhlobo ze-insulin zihlukaniswa ngamaqembu ngokusuka kwimvelaphi, isikhathi sokuvela nesikhathi saso.

Ngokwemvelaphi

Yonke i-insulin ihlukaniswa ngamaqembu amane ngohlobo lwemvelaphi:

Isizukulwane sokuqala i-insulin
Isizukulwane sesibili i-insulin
I-insulin yesizukulwane sesithathu
Isizukulwane sesine se-insulin

Isifinyezo sezinkomo kulolu hlobo lwe-insulin simele izinkomo, ngoba sivela kuso (futhi futhi nasezingulubeni) lapho umuthi utholakala khona.

Lolu hlobo lomuthi, ngokungafani ne-insulin yomuntu, luvame kakhulu ukucasula ukubukeka kokungezwani komzimba, ngoba liqukethe kuphela i-20% yokungcola ngendlela ye-somatostatin, i-proinsulin, i-glucagon namanye ama-polypeptides.

Kukhona i-amino acid eyodwa engulubeni ye-insulin (i-monopic), kepha futhi lokhu akuqinisekisi ukuthi umuntu ngeke abe nomthelela kuyo.

Ukuthola lesi sidakamizwa, kusetshenziswa i-pancreatic pork gland, evumela ukuthi uthole ukungcola okungu-1.5% kuphela.

Lokhu kulungiswa okuzenzakalelayo okuhlanzwa okungu-100%. Kuphephile kunezinketho zangesikhathi esedlule, ngoba ayivusi ukubonakala kwe-hypoglycemia.

Lezi zihlukahlukene zezincazelo ze-insulin ezakhiwe ngofuzo nomuthi womuntu. Lezi zinhlobo ze-insulin zenziwa kusetshenziswa izindlela ezahlukahlukene.

I-insulin yomuntu itholakala ngokuhlanganiswa kwe-Escherichia coli, futhi i-insulin eyenziwe nge-genetic etholakala kulungiso lwe-porcine, kulokhu kuphela i-amino acid ithathelwa indawo.

Iqembu lokugcina lomuthi libhekwa njengomuthi omuhle kakhulu futhi owamukelekayo obangela ukulimala okuncane emzimbeni ngendlela yokungezwani komzimba neminye imiphumela emibi. Ku-insulin yalezi zinhlobo ayikho iprotheni yakwelinye izwe, ngakho-ke ilungele kakhulu abantu.

Ukulebula kwezidakamizwa

Lapho uthenga i-insulin ngokubhala, ungazitholela ngokwakho ukuthi lingeliphi iqembu nokuthi ihlanzwe kanjani.

Ngakho:

Uma iphakethe limakiwe I-MS, lapho-ke uphethe ukulungiswa kwengxenye eyodwa (okuhlanza monocomponent).
Ukumaka MN kusho ukuthi manje usezandleni zakho i-analog ye-insulin yabantu.
Ngaphezu kwezifinyezo, lawo malungiselelo angabhalwa ngamanani. I-40 noma i-100 kwiphakeji izosho ukuthi mangaki amayunithi e-hormone akhona kulo muthi nge-1 mg. Inani le-100 noma ngaphezulu lisho ukuthi umkhiqizo uqukethe i-hormone ekhuphukayo, okungukuthi, yi-penphilic. Ukwamukela ithuluzi elinjalo, amasirinji akhethekile ayadingeka. Imvamisa, izidakamizwa ezinjalo sezivele zithengisiwe kulawa masirinji.

Ukufingqwa okunjalo kubaluleke kakhulu ngesikhathi sokutholwa kwe-insulin, ngoba udinga ukusebenzisa ukubukeka okufanayo ngaso sonke isikhathi.

Ngesikhathi sokuchayeka

Isikhathi somuthi ekusebenzeni ngokomtholampilo sibaluleke kakhulu.

Ngakho-ke, i-insulin ihlukaniswe ngamaqembu alandelayo ngokwesikhathi sokwenza kwayo:

Ibanga Lifushane (ICD)
Ijubane eliphakeme
Isikhathi esimaphakathi sokusebenza (ISPD)
Izinto ezisebenza isikhathi eside (IDD)

Ngemuva kokuthatha umuthi waleli qembu, uqala isenzo salo phakathi nesigamu sehora, kodwa umphumela walo omkhulu utholakala emahoreni angama-1-4 ngemuva kokuwusebenzisa. Kuhlala amahora ama-5-6.

Kunconywa ukwethula lolu hlobo lwe-insulin ngaphambi kokudla imizuzu engu-15 ukuya kwengama-20. Ngemuva kokwethulwa kwayo, kunconyelwa "ukuluma" ngokuthile, ungasebenzisa izithelo noma okunye ukudla okungekho "okusindayo".

Ibizwa ngokuthi umuthi olula noma omfishane obamba ongezansi. Umphumela wazo utholakala ngokushesha ngemuva kokuphatha, okuphezulu kwenzeka emahoreni angama-1-1,5.

Isikhathi sokusebenza sithatha amahora angama-3-4. Sebenzisa lezi zinhlobo zemithi ikakhulukazi ngemuva kokudla noma ngaphambi kwayo.

Umuntu uzwa umphumela wesidakamizwa ngemuva kwemizuzu engama-30-60, kodwa ukusebenza okuphezulu kungazwakala kuphela ngemuva kwamahora angama-4-10.

Lo mphumela uthatha cishe amahora angama-10 kuye kwangama-20. Imvamisa, umuntu udinga imijovo engama-2-3 yalolu hlobo lwe-insulin ngenxa yokuthi umphumela wayo awuzwakali ngokushesha.

Ngemuva kokusetshenziswa kwayo, umuntu uqala ukuzwa ukuqala komuthi ngemuva kwamahora angama-3-4, futhi umphumela omkhulu utholakala kuphela ngemuva kwamahora angama-8-18. Lo mphumela uthatha cishe amahora angama-24- 28.

Lolu hlobo lwe-insulin lufuna ukuthatha izikhathi eziyi-1-2. Lesi sidakamizwa kufanele sidliwe njalo, ngoba sisebenza emzimbeni ngokuqongelela kwawo.

Inhloso yokwelashwa okuthile kwe-insulin kuncike ezicini eziningi, ezichazwe ngezansi.

Ungayikhetha kanjani i-insulin?

Njengoba wonke umuntu esazi, vele akunakwenzeka ukukhetha isidakamizwa esisodwa sokwelapha isifo esithile. Isifo ngasinye sisodwa, kuyafana nokubekezelela izidakamizwa.

Ukuze ukhethe uhlobo olufanele lwe-insulin esigulini ngasinye ngokunemba ngangokunokwenzeka, kufanele ubheke lezi zinto:

Ukusabela komzimba ohlotsheni ngalunye lomuthi, okungukuthi, isilinganiso sokumunca, ubude bomphumela kanye nokuvela kokuvela komzimba.
Imikhuba yomuntu ngamunye. Kufanele kubhekwe nakanjani, ngoba kungathinta ukubona kwe-insulin ngumzimba (inani lotshwala obudliwayo, umkhuba wokubhema, umlutha wemikhiqizo ethile, njll.)
Inani lemijovo. Njengoba abanye abantu behluleka nje ukuthola umjovo we-insulin ngesikhathi esithile, udokotela angakhetha umuthi, ngokwesibonelo, uzodinga ukusebenzisa izikhathi ezi-1 noma ezi-2, hhayi u-3.
Imvamisa abantu badinga i-insulin lapho izinga labo ushukela lidlula amazinga ajwayelekile, ngakho-ke kufanele likalwe ngezikhathi ezithile. Inani lezilinganiso kuzophazamisa nokukhethwa kwezidakamizwa.
Iminyaka yesineke. Esigabeni ngasinye sobudala, udokotela angakhetha umuthi ngamunye.
Izinkomba zomuntu ngamunye umphumela wezinga likashukela.

Ngezinhloso ezijwayelekile, uhlobo ngalunye lwe-insulin lunqunyelwe ezimweni ezinjalo. Umuthi ngamunye unqunywa ngesikhathi sikashukela ketoacidosis, hyperosmolar coma noma isifo sikashukela se-ketoacidotic.

Izidakamizwa ezejwayelekile

ICD evame kakhulu inegama:

insuman ngokushesha,
i-actrapid
I-Actrapid NM
I-Actrapid MS,
i-humulin ejwayelekile
Iletin ejwayelekile, njll.

Ukunaka! Kuyenqatshelwe ngokuphelele ukusebenzisa imithamo emikhulu ye-ICD. Ngomthelela ongcono futhi ugweme ukusabela komzimba, lesi sidakamizwa kufanele siphathwe ngemithamo emincane, kepha kaningi.

I-Insulin Isikhathi Esimaphakathi ine-ISPD esifushane. Kubekelwe izifo ezifanayo nenketho engenhla. Lokhu kusebenza nakwezinye izinhlobo zezidakamizwa. Izidakamizwa ezivame kakhulu ze-ISPD zibizwa ngokuthi:

insuman basal,
protafan, njll.

Ukunaka! Lolu hlobo lwe-insulin lungaxutshwa, kepha kuphela ngezidakamizwa ezifanayo ezisebenza ngokufushane kunoma yisiphi isilinganiso. Kuyaluleka ukuthi isidakamizwa esingeziwe esihlanganiswa ne-ISPD sidalwe ngesisekelo se-protamine Hagedorn (I-NPH) engathathi hlangothi. Qikelela lapho uxuba lolu hlobo lwe-insulin nezidakamizwa ezisebenza isikhathi eside, ngoba lokhu akunakwenziwa.

Imithi ejwayelekile ye-IDD babe negama:

humulin ultralente,
Glargin
i-ultratard nm.

Ukunaka! Amalungiselelo we-insulin asebenza isikhathi eside angahlanganiswa nezidakamizwa ezisebenza kafushane (ezilula). Izingxube ezinjalo cishe kuzo zonke izitolo zezidakamizwa zithengiswa zenziwe ngomumo. Izilinganiso zabo zingahluka kakhulu (10:90; 20: 80 ... 50:50). Lokhu kwenza kube lula kubantu asebekhulile abanombono ophansi ukuthatha umuthi futhi bawufake umthamo ngokunembe ngangokunokwenzeka. Ukufakelwa okunjalo kuqala ukusebenza kungekudala futhi umphumela uhlala isikhathi eside impela.

Yebo, okuthengwa kakhulu njalo i-insulin ephezulu unamagama:

Isi-Humalog,
I-Apidra
Isazi sezinhlungu.

Izindlela zokugcina amazinga e-insulin

Lo mphumela ungatholakala uma usebenzisa iphampu. Kuluhlobo lwensiza enikeza ukugeleza okungapheli komuthi emzimbeni womuntu. Abanye odokotela babize le divayisi ngokuthi "ama-pancreas okwenziwa ngokungemthetho."

Umgomo wepompo ukuhlinzeka nge-insulin, enezindlela ezimbili:

Isisekelo (ingemuva) imodi. Kuyadingeka ukuze ungene esikhundleni imijovo engapheli ye-insulin. Ngelinye ihora iphampu yethula ngokuzimela umthamo othile womuthi.
Bolus irejimeni ibonakala ngokuphathwa okukodwa kwento kuphela esimweni sokudla (lapho isiguli sithatha inani elithile lama-carbohydrate). Le nqubo ifana kakhulu nomjovo owodwa onesirinji.

Onke amaphampu ayahluka ngesivinini sokulethwa kwe-insulin. Amaphampu ezinkampani ezahlukahlukene angahambisa lo muthi ngejubane elihlukile (kusuka ku-0.01 kuye ku-0.05 u / h). Kubalulekile kakhulu ukukhetha iphampu ecaleni ngalinye.

Kungenzeka ukuthi kulondolozwe izinga elidingekayo le-insulin hhayi ngosizo lwepompo kuphela - isirinji nama-syringes asepeni kusiza abantu abaningi. Inzuzo yabo ngaphezu kwamaphampu yintengo. Isiguli silimaza i-insulin intramuscularly nge-syringe, bese siyikhipha. Izinsimbi zokubhala ziyasebenza futhi.

Imiphumela emibi

Umphumela wecala ovame kakhulu futhi ovame kakhulu kubantu abathatha i-insulin lipodystrophy. Le yi-pathology yezicubu lapho isiguli senza khona umjovo. Kunezikhathi lapho ukuthatha i-insulin esigulini kubangela i-hypoglycemia, okufanele iqedwe ngokushesha ngoshokoledi noma ingilazi yejusi. Le miphumela emibi yenzeka ngenkathi kuthathwa i-insulin (ngendlela ehlanziwe kakhulu). Uma umuntu ethatha i-insulin ngendlela engahlanzwa kangako, kufanele alungele ukubonakala kokungezwani komzimba.

I-insulin yinto ebaluleke kakhulu edingekayo empilweni yomuntu ephelele. Futhi lapho umzimba ngokwawo ungeke uwukhiqize uwedwa, umuntu udinga usizo lwawo lokufakelwa. Leli phuzu elibaluleke kakhulu, ngoba umuntu ngamunye udinga umthamo wakhe we-insulin. Ukubonisana nodokotela kuleli cala kumane nje kudingekile, kungenjalo ungafaka impilo yakho engcupheni.

Kwabashukela, lonke lolu lwazi olungenhla lubaluleke kakhulu, ngoba ulwazi ngokusetshenziswa okufanele kwalezi zidakamizwa, imvelaphi yazo, izindlela zokugcina amazinga kashukela nesikhathi sokuvezwa kuzosiza abantu abaningi ukukhetha i-insulin yabo.

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