I-insulin yi-hormone eyinhloko eyehlisela phansi ushukela futhi inesibopho sokulethwa kweglucose kuwo wonke amaseli emzimbeni. Futhi, imisebenzi ye-hormone ukukhulisa ukwakheka kwamaprotheni, amafutha kanye nokusheshisa ukuthutha kwama-amino acid, potassium, magnesium, phosphorus nezinye izinto zegazi.
Uma ama-pancreas, okumele akhiqize i-insulin, aphazamisekile, lapho-ke umzimba uyeka ukuthola amandla ngokudla. Ngenxa yalokhu, amazinga e-insulin ayancipha, futhi nezinga le-glucose egazini, ngakolunye uhlangothi, liyanda. Kodwa-ke, ushukela onjalo awusetshenziselwa injongo yawo okuhlosiwe, ngenxa yokuthi umzimba uthola indlala yamandla bese amaseli awo eqala ukufa.
Le ndlela sikhula ngayo isifo sikashukela. Phambilini, abantu abanalesi sifo babephethwe, kepha namuhla, ngenxa yentuthuko yososayensi nodokotela, bathola ithuba lokuziphilisa ngendlela yosizo lwe-insulin yokwenziwa.
Ukulungiselela kwe-insulin kukhona i-bolus ne-basal. Ezangaphambili zisetshenziselwa ukunxephezela leso simo ngemuva kokudla, kanti okugcina kuhloselwe ukusekelwa okujwayelekile komzimba. Enye yezidakamizwa ezinhle kakhulu kuleli qembu yiBazal insulin.
I-Insulin Bazal: izici eziphambili
Lesi sidakamizwa se-hypoglycemic sisetshenziselwa ifomu lesifo sikashukela esincike ku-insulin. Isakhi esisebenzayo somuthi yi-insulin yabantu.
Umuthi ukumiswa okumhlophe kokuphatha ngokungaphansi. Kungokweqembu lama-insulin nezimpawu zalo, ezinomphumela omaphakathi.
I-Insulin Insuman Bazal GT isebenza kancane, kepha umphumela emva kokuphatha uhlala isikhathi eside ngokwanele. Ukuqagela okuphezulu kakhulu kutholakala emahoreni angama-3-4 ngemuva kokujova futhi kuthathe amahora angama-20.
Umgomo wesidakamizwa kanje:
- yehlisa ijubane i-glycogenolysis ne-glyconeogeneis;
- yehlisa ukugcwala kwe-glucose egazini, yehlisa ijubane le-catabolic, enomthelela ekuphenduleni kwe-anabolic;
- kuvimbela i-lipolysis;
- ivuselela ukwakheka kwe-glycogen emisipha, esibindini bese idlulisela ushukela iye phakathi kwamaseli;
- kukhuthaza ukungena kwe-potassium kumaseli;
- isebenzisa ukwakheka kwamaprotheni kanye nenqubo yokuletha ama-amino acid kumaseli;
- kuthuthukisa i-lipogenesis esibindini kanye naku-adipose izicubu;
- ikhuthaza ukusetshenziswa kwe-pyruvate.
Kubantu abaphilile, isigamu sempilo yesidakamizwa esivela egazini sithatha imizuzu emi-4 kuye kweli-6. Kepha ngezifo zezinso, isikhathi siyanda, kepha lokhu akuwuthinti umphumela we-metabolic womuthi.
Imiyalo yokusebenzisa umuthi
Udokotela oholayo kuphela okufanele akhethe umthamo wokulungiselela i-insulin ngokususelwa kwimpilo yesiguli, imisebenzi kanye nokudla. Futhi, inani libalwa ngesisekelo sezinkomba ze-glycemia kanye nesimo se-carbohydrate metabolism.
Umthamo ojwayelekile wosuku nosuku usukela ku-0,5 uye ku-1,0 IU / nge-1 kg yesisindo. Kulokhu, u-40-60% womthamo unikezwa i-insulin ende.
Kuyaqapheleka ukuthi lapho ushintsha ushiya i-insulin yezilwane uye kolomuntu, ukunciphisa umthamo kungadingeka. Futhi uma kudluliswa kwenziwa kusuka kwezinye izinhlobo zezidakamizwa, khona-ke ukubhekwa kwezokwelapha kuyadingeka. Ukunakekelwa okukhethekile kufanele kuthathwe ukuqapha i-carbohydrate metabolism ezinsukwini zokuqala eziyi-14 ngemuva koguquko.
I-Insulin Bazal ihanjiswa ngaphansi kwesikhumba emizuzwini engama-45-60. ngaphambi kokudla, kepha kwesinye isikhathi isiguli sinikezwa imijovo ye-intramuscular. Kuyaqapheleka ukuthi ngaso sonke isikhathi indawo lapho kuzokwethulwa khona umjovo kumele ishintshwe.
Wonke umuntu onesifo sikashukela kufanele azi ukuthi i-basal insulin ayisetshenziselwa amaphampu e-insulin, kubandakanya nalawo afakiwe. Kulokhu, ukuphathwa kwezidakamizwa kufakwa emgomeni.
Ngaphezu kwalokho, umuthi akufanele uhlanganiswe nama-insulin anokuhlushwa okuhlukile (isibonelo, i-100 IU / ml no-40 IU / ml), nezinye izidakamizwa kanye nokufakwa kwezilwane. Iqoqo le-Basal Insulin ku-vial yi-40 IU / ml, ngakho-ke kufanele usebenzise kuphela isirinji zepulasitiki eziklanyelwe ngqo lokhu kugxotshwa kwehomoni. Ngaphezu kwalokho, isipetu akufanele sibe nezinsalela ze-insulin yangaphambilini noma omunye umuthi.
Ngaphambi kokuthathwa kokuqala kwekhambi kusuka ku-vial, kuyadingeka ukuvula okuthunyelwe ngokususa ithumba lepulasitiki kuyo. Kepha okokuqala, ukumiswa kufanele kuzanyazanyiswe okuncane ukuze kube mhlophe ngokubabazekayo okuhambisana kokufana.
Uma ngemuva kokuthuthumela umuthi uhlala ubonakala noma izikhala noma umgodi uvela ku-ketshezi, khona-ke lo muthi awunconywa. Kulokhu, kuyadingeka ukuvula elinye ibhodlela elihlangabezana nazo zonke lezi zidingo ezingenhla.
Ngaphambi kokuqoqa i-insulin kwiphakheji, kufakwa umoya omncane esitokisini, bese ufakwa kwi-vial. Ngemuva kwalokho iphakheji iguqulwe ibheke phansi nge-syringe bese kuthi ivolumu ethile yesisombululo iqoqwe kuyo.
Ngaphambi kokwenza umjovo, umoya kufanele ukhululwe kwisirinji. Ukubutha isibaya kusuka esikhunjeni, kufakwa inaliti kuwo, bese isixazululo singene ngaphakathi. Ngemuva kwalokho, inaliti isuswa ngokucophelela esikhunjeni bese kudotshwa uswidi kakotini endaweni yomjovo imizuzwana eminingana.
Ukubuyekezwa kwesifo sikashukela esiningi kubhekela phansi ukuthi ama-syncinges we-insulin ayindlela engabizi, kodwa kungcono ukuphinda uwasebenzise. Namuhla, ukwenza lula le nqubo, kusetshenziswa ipeni elikhethekile lesirinji. Lo ngumshini wokuhambisa i-insulin ongahlala iminyaka emi-3.
Ipeni yesalinji ye-basal GT isetshenziswa kanjena:
- Udinga ukuvula idivaysi, ubambelele engxenyeni yayo yemishini bese udonsela ithoba eceleni.
- Isiphatho se-cartridge asisuswanga kuyunithi yemishini.
- I-cartridge ifakwe kwisibambi, esigoqiwe emuva (yonke indlela) engxenyeni yemishini.
- Ngaphambi kokwethula ikhambi ngaphansi kwesikhumba, ipeni lesirinji kufanele lifudumale kancane ezintendeni zezandla.
- Izimbobo ezingaphandle nezangaphakathi zisuswa ngokucophelela kunaliti.
- Kwibhokisi lebhokisi elisha, umthamo owodwa womjovo ngamayunithi ama-4; ukuyifaka, udinga ukudonsa inkinobho yokuqalisa bese uyiguqula.
- Inaliti (4-8 ml) yepeni yesirinji ifakwa ibheke ngqo esikhunjeni, uma ubude bayo bungama-10-12 mm, khona-ke inaliti ifakwa ekhoneni lika-degrees angama-45.
- Okulandelayo, cindezela ngobumnene inkinobho yokuqalisa yedivaysi bese ufaka ukumiswa kuze kube yilapho kuqhafaza, okubonisa ukuthi inkomba yedosi sehle yafika ku-zero.
- Ngemuva kwalokho linda imizuzwana eyi-10 bese ukhipha inaliti esikhunjeni.
Usuku lokusetha kokumiswa kokuqala kufanele lubhalwe kwilebula ephakeji. Kuyaqapheleka ukuthi ngemuva kokuvula ukumiswa kungagcinwa emazingeni okushisa angaphezu kwama-25 izinsuku ezingama-21 endaweni emnyama futhi epholile.
Imiphumela emibi, i-contraindication, i-overdose
I-Insuman Bazal GT ayinakho ukuphikisana okuningi nokuphikiswa okungalungile. Imvamisa, kuziwa ekubekezelelekeni komuntu ngamunye. Kulokhu, i-edema kaQuincke, ukuphefumula kancane kungakhula, kuthi ukuvela kwemvelo kuqhamuke esikhunjeni kwesinye isikhathi kube kubanda.
Eminye imiphumela emibi ivela ikakhulukazi ekwelashweni okungalungile, ukungahambisani nezincomo zezokwelapha noma i-insulin engafundile. Kulezi zimo, isiguli sihlala sizwa i-hypoglycemia, engahle ihambisane nokungasebenzi kahle kwe-NS, i-migraines, isiyezi ngesifo sikashukela nokukhubazeka kwenkulumo, umbono, ukungazi noma ngisho nokudangala.
Futhi, ukubuyekezwa kwabanesifo sikashukela bathi ngomthamo ophansi, ukudla okungekuhle futhi weqa umjovo, i-hyperglycemia kanye nesifo sikashukela kungenzeka. Lezi zimo zihambisana nokuthakatha, ukozela, ukufoka, ukoma kanye nokudla.
Ngaphezu kwalokho, isikhumba endaweni yomjovo singavunguza, kwesinye isikhathi siqhume kuso. Ngaphezu kwalokho, ukwanda kwe-titer of anti-insulin antibodies kungenzeka, ngenxa yokuthi i-hyperglycemia ingakhula kanjani. Ezinye iziguli zithola ukusabela okuvikelekile kwe-immunological nge-hormone eyenziwe ngomzimba.
Uma kwenzeka kuba ne-insulin ngokweqile, i-hypoglycemia yobunzima obuhlukahlukene ingaqala ukukhula. Ngefomu emnene, lapho isiguli sazi, kudingeka siphuze isiphuzo esiphundu noma sidle umkhiqizo oqukethe i-carbohydrate. Uma kwenzeka ulahlekelwe ukwazi, i-1 mg ye-glucagon ifakwa i-intramuscularly, ngokungasebenzi kwayo, isisombululo se-glucose (30-50%) siyasetshenziswa.
Nge-hypoglycemia ende noma enzima, ngemuva kokuphathwa kwe-glucagon noma i-glucose, ukufakwa ngesisombululo se-glucose esibuthakathaka kunconywa, okuzovikela ukubuyela emuva.
Iziguli ezinkulukazi zilaliswa esibhedlela ngokunakekelwa okujulile ukuze ziqaphe isimo sabo.
Imiyalo ekhethekile
I-Insulin Bazal akufanele isetshenziswe nenqwaba yezidakamizwa. Lokhu kufaka phakathi izidakamizwa ezinomphumela we-hypoglycemic, ama-IAF, ama-disopyramid, ama-pentoxifylline, ama-mimonoamine oxidase inhibitors, i-fluoxetine, i-fibrate, i-propoxyphene, ama-hormone ocansi, ama-anabolics nama-salicylates. Futhi, i-insulin ye-basal akufanele ihlanganiswe ne-Phentolamine, i-Cybenzoline, i-Ifosfamide, iGuanethidine, iSomatostatin, i-Fenfluramine, i-Phenoxybenzamine, iCyclophosphamide, iTrophosphamide, i-Fenfluramine, i-sulfonamides, iTrokokvalin, i-tetracyclines,
Uma usebenzisa i-insulin eyisisekelo ndawonye ne-Isoniazid, Phenothiazine derivatives, Somatotropin, Corticotropin, Danazole, progestogens, glucocorticosteroids, Diazoxide, Glucagon, diuretics, estrogen, Isoniazid nezinye izidakamizwa kungawenza buthaka kakhulu umphumela we-insulin. Umphumela ofanayo ukhishwa ngosawoti we-lithium, i-clonidine ne-beta-blockers.
Inhlanganisela ne-ethanol yenza buthaka noma ibangele umphumela we-hypoglycemic. Lapho ihlanganiswa nePentamidine, i-hypoglycemia ingakhula, kwesinye isikhathi iba yi-hyperglycemia. Uma uhlanganisa ukusetshenziswa kwe-insulin nezidakamizwa ezinobubele, khona-ke buthaka noma ukungabikho kokusebenza kwe-Reflex kwe-NS enozwela kungenzeka.
Uhlobo lwesilinganiso samaqembu athile eziguli lukhethwa ngawodwana. Ngakho-ke, kuma-diabetics asebekhulile kanye neziguli ezine-hepatic, ukwehluleka kwezinso, ngokuhamba kwesikhathi, isidingo se-insulin siyancipha. Futhi uma umthamo ungakhethwanga kahle, khona-ke iziguli ezinjalo zingakhula i-hypoglycemia.
Kuyaqapheleka ukuthi nge-stenosis ye-cerebral or coronary artery and proliferative retinopathy (esimweni sokuvezwa kwe-laser), kuyadingeka ukubheka ngokucophelela izinga le-glycemia. Ngoba, kulezi zimo, ukwehla okunamandla kwamazinga kashukela kungaholela ekulahlekelweni ngokuphelele kombono.
Ngesikhathi sokukhulelwa, ukwelashwa nge-Insuman Bazaol GT kufanele kuqhubeke. Kuhle ukukhumbula ukuthi ngemuva kwe-trimester yokuqala, isidingo se-insulin siyokhuphuka. Kodwa ngemuva kokubeletha, isidingo, kunalokho, sizokwehla, ukuze i-hypoglycemia ku-mellitus yesifo sikashukela ibonakale futhi kuzodingeka ukulungiswa kwe-insulin.
Ngesikhathi sokukhishwa komzimba, ukwelashwa kwe-insulin kufanele kuqhubeke. Kepha kwezinye izimo, ukulungiswa kokudla nokudla kungenzeka kudingekile.
Izindleko ze-insulin Bazal zisukela ku-1228 kuya ku-1600 rubles. Intengo yepeni yesirinji iyahlukahluka kusuka kuma-ruble ayi-1000 kuya kwangama-38 000.
Ividiyo ekulesi sihloko ikhombisa ukuthi ungayijova kanjani i-insulin kahle.
