Amalungiselelo we-insulin asetshenziselwa ukwelashwa okufaka esikhundleni seziguli ezinesifo sikashukela. Ihlukaniswe isikhathi sesenzo ibe mfushane futhi sandiswe. Isikhathi sokwenza izinto kubantu abahlukile. Ngakho-ke, ukukhethwa kokulashwa kwe-insulin kuvame ukwenziwa esibhedlela.
Kuze kube manje, lawula izinga le-glycemia phakathi nosuku. Ngemuva kwalokho udokotela unquma imithamo ye-insulin ngokuya ngesilinganiso se-metabolic, ukudla, ukusebenza komzimba, ukuhlanganisa izinhlobo ezahlukene zemithi.
I-carbohydrate metabolised enxephezelwe kakhulu, ukuguquguquka okuncane kwansuku zonke kushukela wegazi, futhi, ngakho-ke, kunciphisa ingozi yezinkinga zesifo sikashukela.
Imithetho eyisisekelo yokwelashwa kwe-insulin
Imvamisa, kukhiqizwa i-insulin engu-23-59 IU ye-insulin, lokhu kumayelana ne-1 kg yesisindo somzimba - 0.6 - 1.0 IU. Lokhu secretion ihlukaniswe yaba basal nokudla (bolus). Ukuvikelwa okuyisisekelo kwe-insulin kufinyelela ku-1 iyunithi ngehora. Ukugqugquzelwa ukudla, ukukhiqizwa nokukhululwa kwe-insulin - iyunithi eli-1 kuwo wonke ama-10 noma ayi-12 g ama-carbohydrate (1XE).
Isidingo se-insulin sikhulu ekuseni, futhi ukuzwela kuyanda kukho kusihlwa. Lokhu kubalulekile ukwenza uhlelo lokuphathwa kwezidakamizwa, ngoba inhloso yokwelashwa kwe-insulin ukwenza amalungiselelo e-insulin ngezikhathi ezithile zokuzitholela kwabo.
Le ndlela ibizwa ngokuthi isisekelo-isisekelo-sebus sokulawulwa kwe-insulin. Kungaphansi kwesisekelo sokuqina kwe-insulin nokusetshenziswa kwe-insulin. Gqugquzela ukukhululeka kwe-insulin ngokwesilinganiso, ngaphandle kwama-carbohydrate (ushukela), ama-amino acid namaprotheni.
Kwethulwa i-insulin kunamazinga ahlukile okufaka, okuncike ezintweni ezifana nalezi:
Okubaluleke kakhulu kwalokhu okulandelayo:
- Izinga lokushisa lamalungiselelo e-insulin, i-solubility yalo.
- Umthamo wekhambi elifakiwe.
- Izindawo zokujova (ngokushesha kusuka esikhunjeni sesisu, kancane ukusuka ethangeni noma ehlombe).
- Umsebenzi womzimba.
- Izimo Zesineke Zenqubo Yesineke
Inhloso yokwelashwa kwe-insulin: Vozulim N, izinkomba
I-insulin ibekiwe ukuze i-metabolism ye-carbohydrate ifane. Ngokufanelekile, lokhu kusho ukufinyelela ushukela ojwayelekile wegazi, ukuvimbela ukwanda okubukhali ngemuva kokudla, akumele kube khona ushukela kumchamo, akukho ukuhlaselwa kwe-hypoglycemia.
Izinkomba ezigculisayo zokunemba kwendlela yokwelashwa ukunciphisa noma ukuqeda kwezimpawu eziphambili zesifo sikashukela, ukungabikho kwe-ketoacidosis, i-hyperglycemia enamandla, ukuhlaselwa njalo kwe-hypoglycemia.
Ukwelashwa nge-insulin kukuvumela ukuthi ulondoloze isisindo somzimba esivamile seziguli futhi udle ukudla okuqukethe ama-carbohydrate (ngaphandle kwalawo alula), gcina isilinganiso esijwayelekile sama-lipoproteins, cholesterol.
Umgomo wokugcina wokwelashwa kwe-insulin yindlela yokuphila ejwayelekile, amandla okugcina ukuxhumana nabantu. Ukuphathwa ngesikhathi nangendlela efanelekile kwe-insulin kusiza ukuvimbela noma kunciphise izinkinga zesifo sezinzwa kanye nemithambo yegazi.
Izinkomba eziphambili zokunquma umuthi oqukethe i-insulin yesifo sikashukela yile:
- Uhlobo lokuqala lwesifo sikashukela.
- I-ketoacidosis (ehlukahluka kubukhali).
- I-Coma: hyperosmolar, ketoacidotic, lactic acidosis.
- Ukutheleleka kobukhulu obulinganisile kanye nezinqubo ezinzima ze-purulent.
- Isifo sofuba
- Ukwehla kwesisindo okungazelelwe.
- I-pancreatitis evamile, i-pancreatectomy, i-pancreatic necrosis.
I-insulin isetshenziswa kungakhathalekile ukuthi hlobo luni lwesifo sikashukela lapho kukhona ama-microangiopathies anezinkinga zomzimba, ukungasebenzi kahle kwegazi okubuthakathaka kwengqondo nokufakelwa kwe-myocardial, ukungenelela kokuhlinzwa.
Kuhlobo 2 sikashukela i-mellitus, i-insulin nayo ikhonjiswa ukumelana nezidakamizwa zomlomo kanye ne-hypertriglyceridemia enkulu, isetshenziswa uma kunesifo sikashukela esingakhokhwanga.
Ungangena kanjani kwiVulim N?
Umuthi yi-insulin yomuntu, isofan, etholakala ngobunjiniyela bezakhi zofuzo. Ifomu lomthamo ukumiswa kokuphathwa ngaphansi kwesikhumba. I-millilita eyodwa iqukethe ama-PIECES ayi-100 we-insulin. Kutholakala ku-10 ml vials kanye nama-cartridges ane-3 ml.
Ukuze ungene kwi-Vozulim N, kufanele wazi ukuthi ungawujova kanjani kahle i-insulin. Ngaphambi kwesingeniso, udinga ukuthatha ibhodlela esiqandisini ngemizuzu engama-30. Hlola usuku lokukhishwa kanye nosuku lokuphelelwa isikhathi. Umuthi ose kuphelelwe isikhathi noma ovulwe ngaphezu kwezinsuku ezingama-28 ezedlule awukwazi ukwenziwa.
Umjovo kufanele wenziwe kuphela izandla ezigeziwe nezomile eskhumbeni esihlanzekile (utshwala akufanele buhlanjululwe). Ibhodlela le-insulin i-Vozulim N lidinga ukugoqulwa ezandleni ukuze umbala wokumiswa ube mhlophe ngokufana, unamafu.
Uma umjovo wenziwa nge-syringe, kumele kulandelwe imithetho elandelayo:
- Ungathinti inaliti nganoma iyiphi indawo.
- Bheka ngokucophelela umthamo we-insulin.
- Indawo yomjovo akufanele ibe seduze kwama-moles (eduze kuka-2,5 cm) noma inkaba, awukwazi ukuphonsa endaweni yokulimala noma ukuvuvukala.
- Ngemuva komjovo, isirinji kufanele ibe ngaphansi kwesikhumba eminye imizuzwana emi-5.
- Inaliti nesirinji kufanele kulahlwe ngokucophelela ngemuva kokuthi kwenziwe umjovo.
Ngokwethulwa kwezidakamizwa ngopeni wesirinji, udinga ukusetha i-dispenser kuleveli oyifunayo bese ucindezela inkinobho yokuqala. Ngemuva kwalokho, bamba ipeni imizuzwana eyishumi ngaphandle kokuyisusa esikhunjeni. Inaliti esetshenzisiwe kufanele ilahlwe ngokushesha.
Indawo yomjovo kumele ishintshwe, uzenzele uhlaka lwakho. Ukuze wehlise ukudabuka, udinga ukuba nenalithi emfishane futhi emifushane.
Ngabe uVulim N usebenza kanjani ngemuva kokuphatha?
I-Vozulim N i-insulin ephakathi nendawo yesikhathi sobuntu. Ukuze uqale ukwehlisa ushukela wegazi, kufanele uxhumeke kwi-receptor ethile kulwelwesi lwangaphandle lweseli. UVozulim N wenza isakhi se-insulin + receptor esivusa ukusabela kwe-biochemical intracellular reaction.
Ukwehla kwe-glycemia kuhlotshaniswa nokufakwa kweglue kakhulu ngamaseli nokufakwa kwayo ezinqubweni ze-metabolic ze-glycolysis zamandla. I-insulin inamandla okusheshisa ukwakhiwa kwamafutha nama-glycogen. Kumaseli wesibindi, ukwakhiwa kwama-molecule amasha eglucose kanye nokuqhekeka kwezitolo ze-glycogen.
Isikhathi sokusebenza kwe-insulin i-Vozulima N kungenxa yezinga lokumunca. Kuya ngezinto ezimbalwa: umthamo, indlela, indawo yokuphatha. Kulokhu, iphrofayili yesenzo se-insulin ingaphansi kokuguquguquka kweziguli ezihlukile nakulowo umuntu.
Umphumela womuthi uqala ihora eli-1 ngemuva kokuphatha, umphumela omkhulu (wekhonkwane) uphakathi kwamahora ama-2 kuye kwayi-7, isikhathi sokusebenza kweVozulima N amahora angama-18-20. Ubhujiswa yi-insulinase esibindini. Igcotshwa ngokusebenzisa izinso.
Izici zokusebenzisa i-Vozulima N:
- Ingabhekelwa kwabesifazane abakhulelwe nangesikhathi sokuncelisa ibele.
- Umjovo wenziwa ngaphansi kwesikhumba, isixazululo kufanele sibe emazingeni okushisa asekamelweni.
- Ukuphatha okunokwenzeka ngasikhathi sinye nge-insulin emfushane - Vozulim R.
- Sebenzisa i-cartridge yepeni yesirinji kuphela.
- Ngenxa yamandla okudalelwa, ukusetshenziswa kwamaphampu we-insulin akunconyiwe.
Uma i-insulin ibekelwe okokuqala noma ushintsho lwayo lwenzekile, ngokucindezela okukhulu ngokomzimba noma kwengqondo, khona-ke amandla ancishisiwe okushayela imoto kungenzeka. Ukuphathwa kwemishini sekuba ngumsebenzi onobungozi.
Ngakho-ke, awancomi umsebenzi odinga ukunakwa okwandisiwe, ijubane lokuphendula kwengqondo nezimoto.
Imiphumela emibi nezinkinga
Ukuphathwa kwe-insulin kuvame ukuholela ekwehleni koshukela wegazi. Imizwa yeziguli ezinesifo sikashukela ayivezi ngaso sonke isikhathi isithombe sangempela sasemtholampilo. Kwi-neuropathy yesifo sikashukela, ukwehla okukhulu kweglucose yegazi kungenzeka kungabonakali, futhi kwisifo sikashukela esibolile, noma ukuncipha okuncane kwe-glycemia kubangela ukungaphatheki kahle.
Izimpawu zokuhlaselwa kwe-hypoglycemic zihlotshaniswa nokwenza kusebenze kohlelo olungenalingani lokuzwela kanye nokunikezwa okuncishisiwe kwezakhi zomzimba ebuchosheni. Ukuthuthumela, ukulamba, izandla eziqhaqhazelayo, ukukhathazeka kwangaphakathi, ukushuba kwezindebe nolimi, kubonakala buthaka.
Ukubonakaliswa kwe-hypoglycemia kwenzeka ngoba ubuchopho abunazo izitolo zayo ezingama-glucose, futhi lapho ukudla sekuncishisiwe, kubhekana ne-hypoxia ngesiyezi, ubuthakathaka, kanye nezidingo zokudla. Ngemuva kwalokho imizwa yezinzwa idluliselwa kwi-pituitary gland, kukhululwa ama-hormone. Ukwethulwa kwehomoni yokusabela kumenyezelwa ukuvuselela i-glycemia.
Ukwelapha i-hypoglycemia ngezigaba zokuqala kanye nezinga eliphansi, kwanele ukuthatha ushukela, uju, uswidi, amaphilisi kashukela. Ezimweni ezibucayi kanye nokuqwashiswa okungasebenzi kahle, iziguli kufanele ziphuthunyiswe esibhedlela lapho i-glucose ilashwa khona ngaphakathi futhi i-glucagon ilimale.
I-hypoglycemia ejwayelekile ku-mellitus yesifo sikashukela iholela ekukhuleni kwe-insulin overdose syndrome (Somoji syndrome). Izimpawu zomtholampilo zazo zimi ngalendlela elandelayo:
- Isidingo esikhulu se-insulin (ukumelana ne-insulin yamanga).
- Inkambo enesifo sikashukela (i-pseudolability).
- Isisindo esizinzileyo noma isisindo esine-glycosuria ephezulu.
- Ukwenza ngcono i-carbohydrate metabolism ngenxa yezifo ezihlangana noma imithamo ephansi.
- Ukwehla kwenhlala-kahle ngethamo elandayo.
- Umuzwa ongapheli wendlala.
- Ukuhlukahluka okukhulu kushukela wegazi kanye nomchamo.
Ukumelana ne-insulin kungakhula, noma umthamo wama-80 amayunithi awulethi umphumela owufunayo, futhi amasosha omzimba ku-insulin atholakala egazini. Ukuphikisana ne-insulin kungokwesikhashana (ngokubambezela, ukunamathisela ukutheleleka, ukwanda kwezifo ezingamahlalakhona noma ze-endocrine) futhi kuqhubeka isikhathi eside.
Ukuphendula okujwayelekile kwe-insulin kuboniswa ngesimo se-Quema se-edema noma i-urticaria ejwayelekile, akuvamile. Ukuphendula kwasendaweni kubonakaliswa ukuvela kwe-hyperemia, ukuvuvukala endaweni yomjovo we-insulin noma ukulunywa kwesikhumba. Imvamisa, ukubonakaliswa kwasendaweni akudingi ukwelashwa futhi kunyamalale ngaphandle kwemiphumela.
I-Lipodystrophy esizeni sokujova kwe-inulin, kanye nezinqubo ze-atrophic ezicutshini ezingaphansi, lapho kufakwa insulin yomuntu, kubangelwa ukwephulwa kokuphathwa kwe-insulin, kanye nokusabela kwe-immunological kwiziguli ezizwela amalungiselelo e-insulin. Ngokuvimbela, udinga ukushintsha indawo yomjovo.
Ekuqaleni kokwelashwa kwe-insulin noma ngokukhuphuka komthamo ophathisiwe, i-insulin edema iyakhula, enyamalala ngaphandle kokusebenzisa okokuhlinzwa ngenyanga. Lokhu kuhlotshaniswa nokukhula kokuphendula kwe-immunological kanye nokugcinwa kwe-sodium emzimbeni.
I-edema enjalo inokwenzeka ekulimazekeni okubonakalayo kwesikhashana ekuqaleni kokusetshenziswa kwamalungiselelo we-insulin. Ilensi ishintsha ubukhulu futhi iziguli zithola umbono wesikhashana wokufiphala nobunzima bokufunda. Lesi sici sinokuqhubeka kusuka kumaviki ambalwa futhi asidingi ukwelashwa noma ukukhetha izingilazi ukuze silungiswe.
Ividiyo ekulesi sihloko ikhombisa inqubo yokuphathwa kwe-insulin.
