Ukusebenza ngokuphelele komzimba womuntu akunakwenzeka ngaphandle kwe-insulin. I-hormone edingekayo ekucutshungweni kwe-glucose, eza nokudla, ibe namandla.
Ngenxa yezizathu ezahlukahlukene, abanye abantu banokuntuleka kwe-insulin. Kulokhu, kunezidingo zokwenziwa kwehomoni yokufakelwa emzimbeni. Ngale njongo, i-insulin Degludek isetshenziswa kaningi.
Umuthi yi-insulin yomuntu enomphumela omude owengeziwe. Umkhiqizo ukhiqizwa ngokusebenzisa i-biotechnology ye-DNA esebenza ngokunye usebenzisa i-Saccharomyces cerevisiae uhlobo.
Ikhemisi
Umgomo wokusebenza kwe-Degludek insulin uyafana nalowo wehomoni yomuntu. Umphumela wehlisela ushukela ususelwa ekuvuseleleni inqubo yokusetshenziswa ushukela ngama-tishu ngemuva kokubopha kuma-fat and cell cell receptors futhi ngasikhathi sinye ukwehla izinga lokukhiqizwa koshukela isibindi.
Ngemuva komjovo owodwa wesisombululo kungakapheli amahora angama-24, kuba nomphumela ofanayo. Isikhathi somphumela singaphezu kwamahora angama-42 kuhla lomthamo wokwelapha. Kuyaqapheleka ukuthi ubudlelwano obusezingeni eliphezulu basungulwe phakathi kokukhuphuka kwenani lomuthi kanye nomphumela wawo we-hypoglycemic jikelele.
Awukho umehluko obalulekile emtholampilo kwi-pharmacodynamics ye-Degludec insulin phakathi kweziguli ezisencane nezindala. Futhi, ukwakheka kwama-antibodies ku-insulin akuzange kutholakale ngemuva kokwelashwa ne-Deglyudec isikhathi eside.
Umphumela wesikhathi eside somuthi kungenxa yesakhiwo esikhethekile se-molecule yaso. Ngemuva kokuphathwa kwe-sc, kwenziwa amayeza amzimba aqinile we-soluble, akha uhlobo “lwedepho” lwe-insulin kwezicubu ze-subcutaneous adipose.
Ama-Multihexamers ahlukanisa kancane, okuholela kokukhishwa kwama-monemors e-hormone. Ngakho-ke, ukuhamba kancane kwesixazululo esijikeleza ukungena kwegazi kwenzeka, okuqinisekisa iphrofayli lesenzo eside, nokuhlala isikhathi eside nomphumela oqinile wokunciphisa ushukela.
Ku-plasma, i-CSS itholakala ezinsukwini ezimbili noma ezintathu ngemuva komjovo. Ukusatshalaliswa kwalo muthi kungokulandelayo: ubudlelwano bukaDegludek ne-albhamuin -> 99%. Uma umuthi uphathwa ngokungaxhunyiwe, khona-ke okuqukethwe okuphelele kwegazi kuyalingana kumthamo olawulwa ngaphakathi komthamo wokwelapha.
Ukweqiwa komuthi kuyefana nasendabeni yomshuwalense womuntu. Onke ama-metabolites enziwe enqubweni awasebenzi.
Ngemuva kokuphathwa kwe-sc ye-T1 / 2 kunqunywa isikhathi sokufakwa kwayo ezicutshini ezingaphansi, okungamahora angama-25, kungakhathalekile umthamo.
Ubulili beziguli azithinti i-pharmacokinetics ye-insulin Degludec. Ngaphezu kwalokho, awukho umehluko okhethekile emtholampilo wokwelashwa kwe-insulin ezinganeni, ezigulini esezikhulile kanye nabanesifo sikashukela abanesibindi sokusebenza kwesibindi nezinso.
Ngokuphathelene nezingane (ezineminyaka engu-6-11 ubudala) kanye nentsha (iminyaka eyi-12-18 ubudala) enesifo sikashukela sohlobo 1, ama-chemacokinetics e-insulin Degludec ayalingani nasezigulini zabantu abadala. Kodwa-ke, ngomjovo owodwa womuthi ezigulini ezinesifo sikashukela sohlobo 1, isilinganiso sonke somuthi ezigulini ezingaphansi kweminyaka engu-18 sikhulu kunaleso sikashukela esidala.
Kuyaphawuleka ukuthi ukusetshenziswa okuqhubekayo kwe-insulin ye-Degludek akuwuthinti umsebenzi wokuzala futhi akunawo umthelela onobuthi emzimbeni womuntu.
Futhi isilinganiso sokusebenza kwe-mitogenic kanye ne-metabolic ye-Degludek ne-insulin yabantu kuyafana.
Imiyalo yokusebenzisa umuthi
Isixazululo kufanele siphathwe ngaphansi kwesikhumba kuphela, futhi ukuphathwa kwe-iv kufakwe ku-contraindication. Ngaphezu kwalokho, ukuhlinzeka ngomphumela ozinzile we-hypoglycemic, injekishini eyodwa ngosuku yanele.
Kuyaphawuleka ukuthi iDegludec insulin iyahambisana nawo wonke amaphilisi okwehlisa ushukela nezinye izinhlobo ze-insulin. Ngakho-ke, ithuluzi lingasetshenziswa njenge-monotherapy noma njengengxenye yokwelashwa okuhlanganayo.
Umthamo wokuqala wesidakamizwa amayunithi ayi-10. Ngemuva kokulungiswa komthamo kancane kancane kwenziwa ngokuya ngezimpawu zesiguli (isisindo, ubulili, ubudala, uhlobo nenkambo yalesi sifo, ukuba khona kwezinkinga).
Uma umuntu onesifo sikashukela ethola olunye uhlobo lwe-insulin noma edluliselwa ku-Degludek (Tresib), khona-ke umthamo wokuqala ubalwa ngokuya ngomgomo 1: 1. Ngakho-ke, inani le-insal insulin kufanele lifane nele-Degludek insulin.
Uma umuntu onesifo sikashukela esekhondweni elifanayo lokuphathwa kwe-insulini yangemuva noma isiguli sinokuqukethwe kwe-hemoglobin ye-glycated engaphansi kwama-8%, khona-ke umthamo ukhethwa ngawodwana. Imvamisa kuyadingeka ukwehlisa umthamo ngokulungiswa kwawo okulandelayo.
Ukubuyekezwa kodokotela kwehla iqiniso lokuthi kungcono ukusebenzisa imithamo emincane ye-insulin. Lokhu kuyadingeka ngoba uma uhumusha ivolumu ibe yi-analogue, khona-ke ukuthola i-glycemia oyifunayo, udinga umthamo ophansi ngisho nomuthi.
Ukuhlolwa okwalandela kwenani elifanele le-insulin kungenziwa kanye ezinsukwini eziyi-7.
I-Titration isuselwe esilinganisweni sezilinganiso ezimbili zangaphambili zokuzila ushukela.
Contraindication, overdose, ukuxhumana kwezidakamizwa
I-Degludec insulin ayithathwa ebuntwaneni, kanye nokungabekezelelani komuntu ngamunye kwizakhi, ngesikhathi sokukhulelwa nokukhulelwa.
Asikho isilinganiso esiqondile esingavusa i-hypoglycemia, kepha lesi simo singakhula kancane. Ukwehla kancane ushukela, isiguli kudingeka siphuze isiphuzo esiphundu noma sidle umkhiqizo onama-carbohydrate asheshayo.
Kwi-hypoglycemia enzima, uma isiguli singazi, sifakwa nge-glucagon noma solution kashukela. Uma ngemuva kokusebenzisa i-glucagon isiguli singaphinde siphaphame, sinikezwa i-dextrose, bese kunikezwa imalimboleko ekudleni okuqukethe i-carbohydrate.
Isidingo se-insulin siyancipha uma sithathwa:
- I-ARG ye-peptide-1;
- amaphilisi we-hypoglycemic;
- I-mao / ACE inhibitors;
- izivimbi ze-beta ezingakhethi;
- ama-sulfonamides;
- ama-anabolic steroid;
- ama-salicylates.
Ama-Thiazide diuretics, ama-hormonal contracepadors omlomo, iDanazol, i-GCS, iSomatropin, ama-sympathomimetics, ama-hormone e-thyroid anegalelo ekwandeni kwesidingo se-insulin. Ukubonakaliswa kwe-hypoglycemia kungabizwa kancane uma iDegludec ithathwa kanye nabathengi be-beta.
ILanreotide, i-Octreotide, ne-ethanol kungakhulisa noma kwehlise isidingo se-insulin. Kuyaphawuleka ukuthi uma izidakamizwa ezithile zengezwa kwikhambi le-insulin, lokhu kungaholela ekubhujisweni kwe-ejenti yama-hormone.
Ngaphezu kwalokho, i-Degludec ayivunyelwe ukungezwa kuzixazululo ze-infusion.
Imiphumela emibi nemiyalo ekhethekile
Umphumela wecala ovame kakhulu yi-hypoglycemia. Imvamisa izimpawu zakhe zivele ngokuzumayo. Ukubonakaliswa okunjalo kufaka i-pallor yesikhumba, indlala, ukubukeka kokujuluka komoya obandayo, ukushaya kwenhliziyo okunamandla, ukukhathala, ukuthuthumela, ikhanda, ukuba novalo, isicanucanu, ukukhathazeka, ukozela, ukubambisana okungahambi kahle nokunganakekelwa. Kungenzeka futhi ukonakala okwesikhashana kwesifo sikashukela.
Ukungezwani komzimba nakho kungenzeka, kufaka phakathi ukusongela kwe-anaphylactic okusongela impilo. Kuyaqabukela engxenyeni yamasosha omzimba, i-urticaria noma i-hypersensitivity kungenzeka. Lesi simo sikhonjiswa ukulunywa kwesikhumba, ukuvuvukala kwezindebe, nolimi, ukukhathala nokucanuzelelwa kwenhliziyo.
Kwesinye isikhathi i-lipodystrophy yenzeka esizeni somjovo. Kodwa-ke, ngokuya ngemithetho yokushintsha indawo yomjovo, amathuba okuphendula okunjalo mancane.
Endaweni yokuphatha, ukuphazamiseka okuvamile nokuphazamiseka kungenzeka. Ngezikhathi ezithile, i-edema yangaphandle iqala ukuvela, kuvame kakhulu kusayithi lomjovo:
- ukuhlangana;
- i-hematoma;
- ukucasulwa
- izinhlungu
- ukulunywa
- hemorrhage yendawo;
- ushintsho umbala wesikhumba;
- i-erythema;
- ukuvuvukala
- izihlunu ezisebenzayo zezicubu.
Ukubuyekezwa kwe-Deglyudeke insulin ithi umuthi ulula futhi ulula ukuwusebenzisa, futhi ngenxa yesenzo esithatha isikhathi eside ngemuva kokwethulwa kwekhambi, izinga le-glycemia lihlala lilijwayelekile isikhathi eside.
Umuthi owaziwa kakhulu osuselwa ku-Degludek uwumkhiqizo ngaphansi kwegama lokuhweba iTresiba. Umuthi uyatholakala njengekhithi enamabhokhethi angasetjenziswa kuphela ezihlalweni zesirinji zaseNovopen ukuze zisetshenziswe kabusha.
I-Tresiba iyatholakala ngamapeni alahlwayo (i-FlexTouch). Umthamo wesidakamizwa ama-PIERES ayi-100 noma angama-200 ku-3 ml.
Izindleko zepeni yeTreshiba Flex Touch ziyahlukahluka kusuka ku-8000 kuya kuma-ruble ayi-1000. Futhi ividiyo ekulesi sihloko izokutshela nje ukuthi uyisebenzisa kanjani i-insulin eyengeziwe.
