Isifo sikashukela isifo sikashukela yisifo lapho izinkinga ze-metabolic, zamasipha nezemizwa zibangelwa ukuntuleka kwe-insulin. Ngohlobo 1 sikashukela, ukuntuleka kwe-insulin kuphelele, ngoba i-pancreas ilahlekelwa amandla ayo okuxubana.
Isifo sikashukela sohlobo 2 senzeka ngemuva kwesizinda sokuntuleka kwe-insulin okuhlobene nokumelana nezicubu kule hormone. Ngohlobo lokuqala lwesifo sikashukela, ukuphathwa kwe-insulin kubalulekile, ngaphandle kokuphathwa kahle kwesidakamizwa, ketoacidosis esisongela impilo iba.
Isifo sikashukela sohlobo 2 singabuye sidle i-insulin, lapho i-insulin yendabuko iyeka ukwenziwa, futhi ezimweni lapho amaphilisi engeke akwazi ukubuyisa i-hyperglycemia. Ungaphatha i-insulin ngendlela yendabuko - ngesirinji noma ipeni lesirinji, okuyithuluzi lesimanje labanesifo sikashukela, elibizwa ngokuthi yipampu ye-insulin.
Ngabe isebenza kanjani iphampu ye-insulin?
Amadivayisi wesifo sikashukela, kubandakanya ipompo le-insulin, ayanda ngesidingo. Inani leziguli liyanda, ngakho-ke, ukulwa nalesi sifo kudinga ithuluzi elisebenzayo lokusiza ukuphatha umuthi ngendlela eqondile.
Idivayisi yiphampu ekhipha i-insulin ngomyalo ovela ohlelweni lokulawula, isebenza ngesisekelo sokuvikelwa kwemvelo kwe-insulin emzimbeni womuntu onempilo. Ngaphakathi kwephampu kune-insulin cartridge. Ikhithi lomjovo elishintshashintshayo i-cannula lifaka i-cannula yokufakelwa ngaphansi kwesikhumba namashubhu ambalwa okuxhuma.
Ukusuka esithombeni unganquma usayizi wedivayisi - iyaqhathaniswa ne-pager. I-insulini ephuma eshalofini edlula emiseleni idabula i-cannula iye kwezicubu ezingaphansi. Indawo eyinkimbinkimbi, efaka idamu kanye ne-catheter yokufakelwa, ibizwa ngokuthi uhlelo lokufaka. Kuyingxenye yokufaka esikhundleni sokuthi isifo sikashukela sidinga ukushintshwa ngemuva kwezinsuku ezingama-3 zokusetshenziswa.
Ukuze ugweme ukusabela kwendawo ekuphathweni kwe-insulin, ngasikhathi sinye nokushintsha uhlelo lokungeniswa, indawo okunikezwa kuyo izidakamizwa iyashintsha. I-cannula ibekwa kaningi esiswini, okhalweni, noma kwenye indawo lapho insulin ifakwa khona ngamasu ajwayelekile okujova.
Izici zephampu yeziguli ezinesifo sikashukela mellitus:
- Ungahlela isilinganiso sokulethwa kwe-insulin.
- Ukusebenza kwenziwa ngemithamo emincane.
- Uhlobo lunye lwe-insulin yesenzo esifushane noma se-ultrashort sisetshenziswa.
- Uhlobo lomuthi olungeziwe lunikezwa i-hyperglycemia ephezulu.
- Ukuhlinzekwa kwe-insulin kwanele izinsuku eziningana.
Idivayisi ikhiqizwa nganoma iyiphi i-insulin esebenza ngokushesha, kepha izinhlobo ze-ultrashort zinenzuzo: iHumalog, i-Apidra noma iNovoRapid. Umthamo uncike kwimodeli yepompo - ukusuka ku-0,025 kuya ku-0 PIECES ngokuhlinzekwa ngakunye. Lawa ma-paramitha wokungena kwe-gazi egazini asondeza imodi yokuphatha eduze nokufihlwa komzimba.
Njengoba isilinganiso sokukhishwa kwe-insulin yangemuva kwe-pancreas asifani ngezikhathi ezihlukile zosuku, amadivaysi anamuhla angabheka lolu shintsho. Ngokuya ngohlelo, ungaguqula isilinganiso sokukhishwa kwe-insulin egazini njalo ngemizuzu engama-30.
Ngaphambi kokudla, idivaysi ilungiselelwe ngesandla. Umthamo we-bolus wesidakamizwa uncike ekubunjweni kokudla.
Izinzuzo zephampu yesiguli
Iphampu ye-insulin ayikwazi ukwelapha ushukela, kodwa ukusetshenziswa kwayo kusiza ukwenza impilo yesiguli ibe ntofontofo kakhudlwana. Okokuqala, i-apparatus inciphisa izikhathi zokushintshashintsha okubukhali kushukela wegazi, okuncike ekushintsheni kwejubane lezinto ezifakwayo ezifakwayo isikhathi eside.
Izidakamizwa ezimfishane nezisebenzisa i-ultrashort ezisetshenziselwa ukukhulisa idivaysi zinomphumela ozinzile futhi ocatshangelwe kahle, ukufakwa kwazo egazini kwenzeka cishe ngokushesha, kanti nemithamo mincane, okunciphisa ingozi yezinkinga zokulimala kwe-insulin yesifo sikashukela.
Iphampu ye-insulin isiza ukunquma umthamo oqondile we-insulin. Lokhu kunaka ukuzwela komuntu ngamunye, ukuguquguquka kwansuku zonke, ukukhiqizwa kwe-carbohydrate, kanye ne-glycemia eqondisiwe kwisiguli ngasinye. Zonke lezi zinhlaka zifakwa ohlelweni, lona uqobo lubala umthamo womuthi.
Ukulawulwa okunjalo kwensiza kukuvumela ukuthi unake inkomba kashukela wegazi, nokuthi mangaki ama-carbohydrate ahlelelwe ukuthi adliwe. Kungenzeka ukuphatha umthamo we-bolus hhayi ngasikhathi sinye, kepha usabalalise ngesikhathi. Lokhu lula kwephampu ye-insulin ngokusho kwabanesifo sikashukela abanolwazi lweminyaka engaphezu kwengu-20 kubalulekile emnyameni omude nasekusetshenzisweni kwama-carbohydrate ahamba kancane.
Imiphumela emihle yokusebenzisa iphampu ye-insulin:
- Isinyathelo esincane ekuphathweni kwe-insulin (i-0.1 PIECES) nokunemba okuphezulu komthamo womuthi.
- Izikhathi ezi-15 zesikhumba ezingaphansi.
- Ukulawulwa koshukela wegazi ngokushintshwa kwesilinganiso sokulethwa kwe-hormone ngokuya ngemiphumela.
- Ukungena ngemvume, ukugcina idatha ku-glycemia kanye nethamo elilawulwa lomuthi lisuka enyangeni eyi-1 liye ezinyangeni eziyisithupha, lizidlulisele kukhompyutha ukuze ihlaziywe.
Izinkomba kanye ne-contraindication zokufaka iphampu
Ukuze ushintshele ekuphathweni kwe-insulin ngompompo, isiguli kufanele siqeqesheke ngokuphelele ukuthi singazibeka kanjani izinhlaka zokuqina kokuhlinzekwa kwezidakamizwa, futhi sazi nethamo le-bolus insulin lapho lidla ama-carbohydrate.
Iphampu yesifo sikashukela ingafakwa ngokucela isiguli. Kuyelulekwa ukuyisebenzisa uma kunobunzima ekunxephezelweni kwalesi sifo, uma izinga le-hemoglobin ye-glycated kubantu abadala lingaphezulu kwe-7%, nasezinganeni - i-7.5%, futhi futhi kunokushintshashintsha okukhulu futhi okungaguquki ekuqoqweni kweglucose egazini.
Ukwelashwa kwe-insulin kukhonjiswa ngamaconsi evamile kashukela, futhi ikakhulukazi ukuhlaselwa okunamandla ebusuku kwe-hypoglycemia, ngomkhuba "wokusa kokusa", ngesikhathi sokubeletha kwengane, ngesikhathi sokubeletha, futhi nangemva kwayo. Kunconywa ukusebenzisa insiza yeziguli ezinemiphumela ehlukile ku-insulin, ezinganeni, ngentuthuko ebambezelekayo yesifo sikashukela se-autoimmune kanye nezindlela zayo ze-monogenic.
Contraindication yokufaka iphampu:
- Ukuhanjiswa kwesiguli.
- Ukuntuleka kwamakhono okuzithiba we-glycemia nokulungiswa kwamthamo we-insulin kuya ngokudla nomsebenzi womzimba.
- Ukugula kwengqondo.
- Umbono ophansi.
- Ukungakwazi kokubhekwa kwezokwelapha ngesikhathi sokuqeqeshwa.
Kuyadingeka ukuthi unake isici sobungozi be-hyperglycemia uma kungekho-insulin isikhathi eside egazini. Uma kunokungasebenzi kahle kwethekhinoloji, lapho isidakamizwa esisebenza esifushane sesiyeziwe, i-ketoacidosis izokhula emahoreni angama-4, bese kuthi kamuva kube nokudangala kwesifo sikashukela.
Iziguli eziningi zidinga insiza yokwelashwa kwe-pump insulin, kodwa kuyabiza impela. Kulokhu, indlela yokuthola isifo sikashukela kungenzeka ukuthi itholwe mahhala ngemali ebekelwe umbuso. Ukuze wenze lokhu, udinga ukuxhumana ne-endocrinologist lapho uhlala khona, uthole isiphetho ngesidingo sendlela enjalo yokusebenzisa i-insulin.
Intengo yedivayisi incike emandleni ayo: umthamo wethangi, amathuba okushintsha kwesibalo, kucatshangelwa ukuzwela umuthi, ukuqina kwe-carbohydrate, izinga lokuqondisa le-glycemia, i-alamu, kanye nokumelana kwamanzi.
Ezigulini ezinombono ophansi, udinga ukunaka ukugqama kwesibuko, umehluko waso nosayizi wefonti.
Ungabala kanjani imithamo yokwelapha i-pump insulin
Lapho ushintshela kwimpompo, umthamo we-insulin wehla cishe ngo-20%. Kulokhu, umthamo we-basal uzoba yingxenye yesidakamizwa sonke esiphathisiwe. Kuqala, ihanjiswa ngezinga elifanayo, bese isiguli silinganisa izinga le-glycemia phakathi nosuku bese sishintsha umthamo, kucatshangelwa izinkomba ezitholakele, kungabi ngaphezu kwe-10%.
Isibonelo sokubala umthamo: ngaphambi kokusebenzisa iphampu, isiguli sathola ama-60 PIECES we-insulin ngosuku. Ukuze uthole impompo, umthamo ungaphansi kwe-20%, ngakho-ke udinga amayunithi angama-48. Kulawa, uhhafu we-basal amayunithi angama-24, kanti okunye okusele ngaphambi kokudla okukhulu.
Inani le-insulin okufanele lisetshenziswe ngaphambi kokudla linqunywa ngesandla ngokuya ngemigomo efanayo esetshenziselwa indlela yendabuko yokuphatha nge-syringe. Ukulungiswa kokuqala kwenziwa eminyangweni ekhethekile ye-pump insulin therapy, lapho isiguli singaphansi kokuqashwa njalo kwezokwelapha.
Izinketho zama-insulin boluses:
- Okujwayelekile. I-insulin ikhishwa kanye. Isetshenziselwa inani elikhulu lama-carbohydrate ekudleni nasekuqukethe okuphansi kwamaprotheni.
- Isikwele. I-insulin isatshalaliswa kancane isikhathi eside. Kuboniswa ukugcwala okuphezulu kokudla ngamaprotheni namafutha.
- Kabili. Okokuqala, kwethulwa umthamo omkhulu, bese kuthi elincane liqhubeke isikhathi. Ukudla ngale ndlela ku-carbohydrate kakhulu futhi kunamafutha amaningi.
- Kuhle. Lapho udla ngenkomba ye-glycemic ephezulu, umthamo wokuqala uyanda. Umgomo wokuphatha uyafana nenguqulo evamile.
Insulin Pump Izinkinga
Iningi lezinkinga zokuphathwa i-pump insulin therapy zibangelwa ukuthi insiza ingahle ibe nokusebenza okungafanelekile: ukungasebenzi kahle kohlelo, i-crystallization yomuthi, ukukhipha i-cannula, kanye nokwehluleka kwamandla. Amaphutha wokusebenza okunjalo kwepompo angadala i-ketoacidosis noma i-hypoglycemia yesifo sikashukela, ikakhulukazi ebusuku lapho kungekho ukulawula inqubo.
Ubunzima bokusebenzisa iphampu buphawulwa yiziguli lapho zithatha izinqubo zamanzi, ukudlala imidlalo, ukubhukuda, ukuya ocansini kanye nalapho ulele. Ukuphazamiseka kubangela nokuba khona njalo kwamashubhu nama-cannulas esikhunjeni sesisu, ingozi enkulu yokutheleleka endaweni yomjovo we-insulin.
Uma ukwazile nokuthola ipompo ye-insulin mahhala, khona-ke inkinga yokuthenga okuncamelayo kokudla okusetshenziswayo ngokuvamile kunzima kakhulu ukuyixazulula. Izindleko zamakhithi angena esikhundleni sendlela esekelwe kumpompo yokusebenzisa i-insulin aphakeme kaningana kunezindleko zokugcotshwa kwe-insulin ejwayelekile noma amapeni wesirinji.
Ukuphuculwa kwedivayisi kwenziwa ngokuqhubekayo futhi kuholela ekwakhiweni kwamamodeli amasha angafaka ngaphandle ngokuphelele ithonya lesici somuntu, ngoba anekhono lokukhetha ngokuzimela ithamo lomuthi, okudingeka ukufakwa kweglue egazini ngemuva kokudla.
Okwamanje, amaphampu e-insulin awabhebhetheki ngenxa yobunzima bokusetshenziswa kwansuku zonke kanye nezindleko eziphakeme zedivayisi namasethi wokufaka wokufaka. Ukusebenziseka kwabo akubonwa yizo zonke iziguli, abaningi bakhetha imijovo yendabuko.
Kunoma yikuphi, ukuphathwa kwe-insulin akunakuba ngaphandle kokuqashwa njalo kwesifo sikashukela, isidingo sokuhambisana nezincomo zokudla, ukuzivocavoca kwesifo sikashukela kanye nokuvakashela i-endocrinologist.
Ividiyo ekulesi sihloko iveza izinzuzo zephampu ye-insulin.
