Ngokuvamile, i-insulin ikhiqizwa ama-pancreas njalo, ingena egazini ngamanani amancane - izinga le-basal. Lapho kudliwa ama-carbohydrate, ukukhishwa okuyinhloko kwenzeka, noshukela ovela egazini ngosizo lwawo ungena emangqamuzaneni.
Isifo sikashukela i-mellitus senzeka uma i-insulin ingakhiqizwa noma inani layo lingaphansi kwesijwayelekile. Ukuthuthukiswa kwezimpawu zesifo sikashukela kwenzeka futhi lapho ama-cell receptors engakwazi ukuphendula kule hormone.
Kuhlobo 1 sikashukela mellitus, ngenxa yokuntuleka kwe-insulin, ukuphathwa kwaso ngendlela yemijovo kuyakhonjiswa. Iziguli zohlobo lwesibili zingabekelwa ne-insulin therapy esikhundleni samaphilisi. Ukwelashwa kwe-insulin, ukudla nokujovwa ejwayelekile ngomuthi kubaluleke kakhulu.
Yeqa umjovo we-insulin
Njengoba ukwelashwa kwesifo sikashukela sohlobo 1 kwenziwa kuphela ngendlela yokwelashwa esikhundleni se-inulin njalo, ukuphatha umuthi okuwukuphela kwendlela yithuba lokugcina amazinga kashukela egazini.
Ukusetshenziswa okufanele kwamalungiselelo e-insulin kungavikela ukuguquguquka okubukhali kushukela futhi kugweme izinkinga zesifo sikashukela:
- Ukuthuthukiswa kwezimo ze-comatose ezisongela impilo: ketoacidosis, lactactacidosis, hypoglycemia.
- Ukubhujiswa kodonga lwe-vascular - micro- kanye ne-macroangiopathy.
- Isifo sikashukela sikashukela.
- Umbono wehlisiwe - i-retinopathy.
- Izilonda zohlelo lwezinzwa - isifo sikashukela sezinzwa.
Inketho enhle yokusebenzisa i-insulin ukuphinda isigqi sayo somzimba sokungena egazini. Kulokhu, kusetshenziswa ama-insulins ezinsuku ezihlukile zomsebenzi. Ukwakha izinga legazi elihlala likhona, i-insulin ehlala isikhathi eside iphathwa izikhathi ezi-2 ngosuku - I-Protafan NM, uHululin NPH, i-Insuman Bazal.
I-insulin emfushane isetshenziselwa ukufaka esikhundleni ukukhishwa kwe-insulin ekuphenduleni ukungena kokudla. Kwethulwa ngaphambi kokudla okungenani izikhathi ezi-3 ngosuku - ngaphambi kokudla kwasekuseni, kwasemini nangaphambi kwesidlo. Ngemuva komjovo, udinga ukuthatha ukudla isikhawu phakathi kwemizuzu engama-20 kuye kwengama-40. Kulokhu, umthamo we-insulin kufanele wakhelwe ukuthatha inani elithile lama-carbohydrate.
Faka insulin ngendlela efanelekile. Kulokhu, izindawo eziphephe kakhulu nezingcono kakhulu yizingxenye zamahlombe ezingasemuva nezangemuva kwamagxa, umphambili wamathanga noma ingxenye yawo yamuva, isisu, ngaphandle kwesifunda sombilical. Ngaso leso sikhathi, i-insulin ephuma esikhunjeni sesisu ingena egazini ngokushesha kunokuba isuka kwezinye izindawo.
Ngakho-ke, kunconywa ukuthi iziguli ekuseni, futhi futhi, uma kudingeka ukunciphisa ngokushesha i-hyperglycemia (kufaka phakathi ukweqa umjovo), faka i-insulin odongeni lwesisu.
I-algorithm yesenzo sikashukela, uma ikhohlwa ukufaka i-insulin, kuya ngohlobo lomjovo ophuthelwe kanye nemvamisa umuntu onaso onesifo sikashukela asisebenzisa. Uma isiguli siphuthelwa umjovo we-insulin osebenza isikhathi eside, khona-ke lezi zinyathelo ezilandelayo kufanele zithathwe:
- Lapho ujovwe amahlandla ama-2 ngosuku - ngamahora ayi-12, sebenzisa i-insulin kuphela emfushane ngokuya ngemithetho ejwayelekile ngaphambi kokudla. Ukunxenxa umjovo ophuthelwe, khuphula ukusebenza komzimba ukunciphisa imvelo ushukela. Qiniseka ukwenza umjovo wesibili.
- Uma isiguli esinesifo sikashukela silimaza i-insulin kanye, okuwukuthi, umthamo wenzelwe amahora angama-24, khona-ke umjovo ungenziwa ngemuva kwamahora ayi-12 kudlule, kepha umthamo wawo kufanele unqanyulwe. Ngokuzayo udinga ukufaka umuthi ngesikhathi esivamile.
Uma weqa ihlumela le-insulin emfushane ngaphambi kokudla, ungangena kuyo ngokushesha ngemuva kokudla. Uma isiguli sikukhumbule ukudlula sekwephuzile, lapho-ke udinga ukwandisa umthwalo - ngena kwezemidlalo, uhambe ngezinyawo, bese ukala izinga loshukela wegazi. Uma i-hyperglycemia ingaphezulu kuka-13 mmol / L, kunconyelwa ukuthi kufakwe amayunithi ama-1-2 e-insulin amafushane ukuvimbela ukugxuma kushukela.
Uma kuphathwe ngokungalungile - esikhundleni se-insulin emfushane, isiguli esinesifo sikashukela silimale isikhathi eside, khona-ke amandla ayo awanele ukucubungula ama-carbohydrate ekudleni. Ngakho-ke, udinga ukukhipha i-insulin emfushane, kepha ngasikhathi sinye ulinganise izinga le-glucose yakho njalo ngemuva kwamahora amabili futhi ube namathebulethi eglue noma amaswidi ambalwa nawe ukuze unganciphisi ushukela ku-hypoglycemia.
Uma ufaka umjovo omfushane esikhundleni se-insulin ende, khona-ke kufanele usawudlulise lojovo ophuthelwe, ngoba udinga ukudla inani elifanele lokudla kwe-carbohydrate ye-insulin emfushane, futhi isenzo saso sizophela ngaphambi kwesikhathi esidingekayo.
Esimweni lapho i-insulin eningi ilimele kunesidingo noma umjovo wenziwe ngokungafanele kabili, lapho-ke kufanele uthathe lezi zinyathelo:
- Khuphula ukuthathwa kwe-glucose kusuka ekudleni okunamafutha amancane ngama-carbohydrate ayinkimbinkimbi - okusanhlamvu, imifino nezithelo.
- Faka i-glucagon, umphikisi we-insulin.
- Kala ushukela okungenani kanye njalo emahoreni amabili
- Yehlisa ukucindezela ngokomzimba nangokwengqondo.
Okunganconywa ngokuphelele ezigulini ezinesifo sikashukela ukuphinda kabili umthamo olandelayo we-insulin, ngoba lokhu kuzoholela ngokushesha ekwehleni koshukela. Into ebaluleke kakhulu lapho weqa umthamo ukuqapha izinga likashukela egazini lize lizinze.
I-Hyperglycemia lapho weqa umjovo we-insulin
Izimpawu zokuqala zokukhuphuka kweglucose yegazi ngomjovo ophuthelwe ukoma okwandayo nomlomo owomile, ikhanda, nokuchama kaningi. Isicanucanu, ubuthakathaka obukhulu kwisifo sikashukela, nobuhlungu besisu kungavela nako. Amazinga kashukela angakhuphuka ngethamo elibalwe ngokungalungile noma umthamo omningi wama-carbohydrate, ukucindezelwa kanye nokutheleleka.
Uma ungathathi ama-carbohydrate ngesikhathi sokuhlasela kwe-hypoglycemia, khona-ke umzimba ungasinxephezela lesi simo ngokwawo, kuyilapho ibhalansi ye-hormonal ephazamisekile izogcina ushukela wegazi ophezulu isikhathi eside.
Ukunciphisa ushukela, udinga ukwandisa umthamo we-insulin elula uma, lapho ulinganiswa, inkomba ingaphezu kwe-10 mmol / l. Ngokwanda lokhu, kuwo wonke ama-3 mmol / l angeziwe, amayunithi angama-0.25 anikezwa izingane zasenkulisa, amayunithi angama-0,5 ezinganeni zesikole, amayunithi ayi-1 kuya kwabasesezingeni lokungena ebusheni nakwabadala.
Uma ukweqa i-insulin kubangelwe yisifo esithathelwanayo, ekushiseni okuphezulu, noma lapho kwenqaba ukudla ngenxa yokudla okuphansi, khona-ke ukuvikela izinkinga ngesimo se-ketoacidosis, kunconyelwa:
- Njalo emahoreni ama-3, ukukala izinga le-glucose egazini, kanye nemizimba ye-ketone kumchamo.
- Shiya izinga le-insulin elingapheli lingashintshiwe, futhi ulawule i-hyperglycemia nge-insulin emfushane.
- Uma i-glucose yegazi ingaphezulu kuka-15 mmol / l, i-acetone ivela kumchamo, khona-ke umjovo ngamunye ngaphambi kokudla kufanele wenyuswe ngo-10-20%.
- Ezingeni le-glycemia elingafika ku-15 mmol / L kanye nokutholakala kwe-acetone, umthamo we-insulin omfushane ukhuphuka ngo-5%, ukwehla ufike ku-10, imithamo yangaphambilini kufanele ibuyiselwe.
- Ngaphezu kwemijovo eyinhloko yezifo ezithathelwanayo, ungaphatha i-humalog noma i-NovoRapid insulin kungakapheli amahora ama-2, kanye ne-insulin elula - ngamahora ama-4 ngemuva komjovo wokugcina.
- Phuza uketshezi okungenani ilitha ngosuku.
Ngesikhathi sokugula, izingane ezincane zingakwenqaba ngokuphelele ukudla, ikakhulukazi lapho kunesicanucanu nokuhlanza, ngakho-ke ziyakwazi ukushintshela kumajusi wezithelo noma amajikijolo okwesikhashana, zinikeze ama-apula agayiwe, uju
Ungakhohlwa kanjani ngomjovo we-insulin?
Izimo zokweqa le dosi kungenzeka zinganciki esigulini, ngakho-ke, ekwelashweni kwesifo sikashukela i-mellitus nge-insulin, wonke umuntu uncoma ama-ejenti enza lula imijovo ejwayelekile:
Incwajana noma amafomu akhethekile wokugcwalisa ngokukhombisa umthamo, isikhathi somjovo, kanye nedatha kukho konke ukukala ushukela wegazi.
Faka isinali kufoni yakho ephathekayo, ikukhumbuza ukuthi ufake i-insulin.
Faka uhlelo lokusebenza ocingweni lwakho, kuthebhulethi noma kwikhompyutha ukulawula amazinga kashukela. Izinhlelo ezikhethekile ezinjalo zikuvumela ukuba ugcine kanyekanye idayari yokudla, amazinga kashukela futhi ubale umthamo we-insulin. Lokhu kufaka uNorma Ushukela, Umagazini weSifo Sikashukela, Isifo Sikashukela.
Sebenzisa izinhlelo zokwelashwa zamagajethi akhombisa isikhathi sokuthatha imishanguzo, ikakhulukazi uma usebenzisa amanye ngaphandle kwamaphilisi we-insulin ekwelapheni izifo ezihlangene: amaphilisi ami, ukwelashwa kwami.
Faka ilebheli isirinji ngamanyimbo womzimba ukugwema ukudideka.
Uma kwenzeka ukuthi umjovo uphuthelwe ngenxa yokungabikho kolunye lwezinhlobo ze-insulin, futhi obungeke ukwazi ukuthengwa, ngoba alukho ekhemisi noma kwezinye izizathu, lapho-ke kungenzeka njengendawo yokugcina ukufaka esikhundleni i-insulin. Uma kungekho-insulin efushane, khona-ke i-insulin ende kufanele ifakwe ngesikhathi lapho inani eliphakeme lesenzo salo lihlangana nesikhathi sokudla.
Uma kune-insulin emfushane kuphela, lapho-ke udinga ukuyijova kaningi, ugxile ezingeni leshukela, kufaka phakathi ngaphambi kokulala.
Uma ngabe ubuphuthelwe ukuphuza amaphilisi okwelapha isifo sikashukela sohlobo lwesibili, khona-ke angathathwa ngesinye isikhathi, ngoba isinxephezelo sokubonakaliswa kwe-glycemia ngemithi yesimanje ye-antidiabetic ayiboshelwe izindlela zokubhala. Kuyenqatshelwa ukuphinda kabili umthamo wamathebulethi noma ngabe imithamo emibili ilahlekile.
Ezigulini ezinesifo sikashukela mellitus, kuyingozi ukuba noshukela omkhulu wegazi lapho weqa umjovo noma amalungiselelo wethebhulethi, kepha ukuthuthukiswa kokuqalwa kwe-hypoglycemic okuvame kakhulu, ikakhulukazi ebuntwaneni, kungaholela ekwakhekeni komzimba okulimala, kufaka phakathi ukukhula kwengqondo, ngakho-ke ukulungiswa okufanele komthamo ofanele.
Uma kukhona ukungabaza ngokunemba kokuphinda kuqalwe kabusha komthamo wezidakamizwa noma ukushintshwa kwezidakamizwa, khona-ke kungcono ukuthola usizo lwezokwelapha olukhethekile kudokotela obambelela endocrinologist. Ividiyo ekulesi sihloko izokhombisa ubudlelwane phakathi kwe-insulin noshukela wegazi.
