Namuhla emhlabeni kunokwanda okukhulu kwesibalo sabantu abanesifo sikashukela. Ngokusho kwezibikezelo, ngo-2035 inani labanesifo sikashukela emhlabeni lizokhuphuka ngamabili futhi lifike ezigulini ezingaphezu kwesigidigidi. Izibalo ezinjalo ezidumazayo ziphoqa izinkampani zemithi ukuthi zikhiqize izidakamizwa ezintsha ngokwengeziwe zokulwa nalesi sifo esingalapheki esibucayi.
Enye yezinto ezifana nalesi sakamuva yisidakamizwa uToujeo, esidalwe yinkampani yaseJalimane iSanofi ngokusekelwe kwi-insulin glargine. Lokhu kuhlanganiswa kwenza iTujeo ibe insulin esezingeni eliphakeme, futhi esebenza isikhathi eside esiza ukulawula kahle amazinga kashukela wegazi, igweme ukuguquguquka okungazelelwe.
Enye inzuzo yeTujeo ukungabikhona ngokuphelele kwemiphumela emibi kanye nezindawo ezinxephezela kakhulu. Lokhu kusiza ukuvimba ukuthuthukiswa kwezinkinga ezinkulu zesifo sikashukela, njengokulimala kwezinhlelo zenhliziyo nezinzwa, okungaholela ekulahlekelweni kombono, ukulimala emaphethelweni nokuphazamiseka kwendlela yokugaya ukudla.
Okungukuthi, impahla enjalo ibaluleke kakhulu emithini yokwelapha isifo sikashukela, ngoba isisekelo sokwelashwa kwesifo sikashukela ngokuqondile ukuvimbela ukwanda kwemiphumela eyingozi yesifo. Kodwa ukuze uqonde kangcono ukuthi iTujeo isebenza kanjani nokuthi ihluke kanjani kuma-analogues ayo, kuyadingeka ukukhuluma ngokuningiliziwe ngalesi sidakamizwa.
Izici Nezinzuzo
I-Tujeo isidakamizwa esisezingeni eliphezulu esikufanele kahle ukwelashwa okwelapha ezigulini ezinesifo sikashukela sohlobo 1 nohlobo 2. Lokhu kunikezwa amandla yi-insulin analogue yesizukulwane sakamuva se-glargin 300, okuyikhambi layo elihle kakhulu lokulwa nokuqina kwe-insulin.
Ekuqaleni kwesifo, iziguli ezinesifo sikashukela esincike ku-insulin zingenza kuphela ngemishanguzo eyehlisa ushukela .Kodwa-ke, ngesikhathi sokuthuthuka kwalesi sifo, zizodinga imijovo ye-insal insulin, okufanele izisize zilondoloze amazinga eglucose ebangeni elijwayelekile.
Ngenxa yalokhu, babhekene nayo yonke imiphumela emibi yokwelashwa kwe-insulin, njengokuqina kwesisindo nokuhlaselwa njalo kwe-hypoglycemia.
Phambilini, ukunciphisa imiphumela emibi ye-insulin, iziguli bekufanele zinamathele ekudleni okuqinile kakhulu futhi zenze inani elikhulu lokuzivocavoca umzimba nsuku zonke. Kepha ngokufika kwezimpawu zesimanje ze-insulin ezinjenge-glargine, isidingo sokulawulwa kwesisindo nokuzimisela kokumisa ukuhlaselwa kwe-hypoglycemia kunyamalale ngokuphelele.
Ngenxa yokwehlukahlukana okuphansi, isikhathi eside sokusebenza, kanye nokudedelwa okuqinile kwezicubu ezingena emzimbeni wegazi, i-glargine akuvamile ukubangela ukwehla okunamandla kushukela wegazi futhi akunikele ekuqongeleleni isisindo somzimba esithe xaxa.
Wonke amalungiselelo asuselwa ku-glargine aphephile ezigulini, ngoba azibangeli ukuguquguquka okukhulu kushukela futhi zivikele kangcono uhlelo lwesifo senhliziyo, njengoba kufakazelwa izifundo eziningi. Ngaphezu kwalokho, ukusetshenziswa kwe-glargine esikhundleni se-detemir ekwelashweni kwe-insulin kusiza ukunciphisa izindleko zokwelashwa cishe yi-40%.
IToujeo akusona isidakamizwa sokuqala esiqukethe ama-molecule e-glargine. Mhlawumbe umkhiqizo wokuqala owawufaka i-glargargin kwakunguLantus. Kodwa-ke, eLantus iqukethe ivolumu engu-100 PIECES / ml, kanti eTujeo ukuhlushwa kwayo kuphindeke kathathu - 300 IZIMPAWU / ml.
Ngakho-ke, ukuthola umthamo ofanayo we-insulin kaTujeo, kuthatha izikhathi eziphansi kathathu kuneLantus, okwenza ukuthi imijovo ingabi buhlungu ngenxa yokwehliswa okukhulu kwendawo eyi-precipitate. Ngaphezu kwalokho, umthamo omncane wesidakamizwa ukuvumela ukuthi ulawule kangcono ukuhamba kwe-insulin ungene egazini.
Njengoba kunendawo encane yokuqothuka, ukumuncwa kwalesi sidakamizwa kusuka ezicutshini ezingasasebenzi kuhamba kancane futhi kube ngisho nangokwengeziwe. Le mpahla yenza iTujeo ngaphandle kwe-analogue ephezulu ye-insulin, esiza ukugcina ushukela usezingeni elifanayo futhi uvikele ukukhula kwe-hypoglycemia
Ngokuqhathanisa i-glargin 300 IU / ml kanye ne-glargin 100 IU / ml, singasho ngokuqiniseka ukuthi uhlobo lokuqala lwe-insulin lunephrofayili ye-pharmacokinetic ebushelelezi nesikhathi eside esisebenza, okungamahora angama-36.
Ukusebenza okuphezulu kakhulu nokuphepha kwe-glargine 300 IU / ml kwabonakaliswa ngesikhathi sokufunda lapho uhlobo lwe-1 yesifo sikashukela semikhakha yobudala ehlukene kanye nezigaba zesifo zahlanganyela khona.
Umuthi Tujeo unezibuyekezo eziningi ezinhle, zombili ezigulini nakwabasebenza kuzo odokotela.
Imiyalo yokusebenzisa umuthi
I-Toujeo iyatholakala ngesimo sesisombululo esikhanyayo, esigcwele emabhokisini engilazi angu-1.5 ml. I-cartridge ngokwayo ifakwe esibayeni sesirinji ukusetshenziswa ngakunye. Kumakhemisi, isidakamizwa sikaTujeo sithengiswa emabhokisini amakhadibhodi, angaqukatha amapeni we-1,3 noma ama-5 syringe.
I-insulin kaTujeo eyisisekelo kufanele iphathwe kanye ngosuku. Noma kunjalo, azikho izincomo ezithile ngokuqondene nesikhathi esifanele kakhulu somjovo. Isiguli uqobo singazikhethela lapho kufaneleka khona ukuphatha umuthi - ekuseni, ntambama noma kusihlwa.
Kuhle uma isiguli sikashukela singakwazi ukufaka i-insulin kaTujeo ngasikhathi sinye. Kodwa uma ekhohlwa noma engenaso isikhathi sokujova ngesikhathi, khona-ke kulokhu ngeke kube nemiphumela empilweni yakhe. Usebenzisa umuthi Tujeo, isiguli sinethuba lokunikeza umjovo emahoreni angama-3 ngaphambili noma amahora ama-3 kamuva kunokuba sinqunyelwe.
Lokhu kunikeza isiguli isikhathi samahora ayi-6 lapho kufanele siphathe khona i-insal insulin, ngaphandle kokwesaba ukwanda koshukela wegazi. Le mpahla yesidakamizwa isiza kakhulu impilo yomuntu onesifo sikashukela, ngoba imnika ithuba lokwenza imijovo endaweni elula kakhulu.
Ukubalwa kwethamo lomuthi kufanele futhi kwenziwe ngokuhlanganyela kwe-endocrinologist. Umthamo osungulwe we-insulin ungaphansi kokulungiswa okuphoqelekile uma kwenzeka kuguqulwa isisindo somzimba wesiguli, ukuguqukela ekudleni okuhlukile, ukukhuphula noma ukunciphisa inani lomsebenzi womzimba futhi kushintshe isikhathi sokulimala.
Lapho usebenzisa i-insal insulin, iTujeo idinga ukukala ushukela wegazi kabili ngosuku. Isikhathi esihle kakhulu salokhu ekuseni nakusihlwa. Kubalulekile ukugcizelela ukuthi umuthi kaTujeo awulungele ukwelashwa kwe-ketoacidosis. Ngale njongo, ama-insulin asebenza ngokufushane kufanele asetshenziswe.
Indlela yokwelashwa ngeTujeo ikakhulukazi ixhomeke kuluphi uhlobo lwesifo sikashukela esiguliswa yilokhu:
- UTujeo onesifo sikashukela sohlobo 1. Ukwelapha okwelapha lesi sifo kufanele sihlanganise imijovo ka-Tujeo esebenza isikhathi eside esebenza njenge-insulin nokusetshenziswa kwamalungiselelo amafushane we-insulin. Kulokhu, umthamo we-insal insulin Tuje kufanele ukhethwe ngokuqinile.
- I-Tujeo enesifo sikashukela sohlobo 2. Ngale ndlela yesifo sikashukela, abakwa-endocrinologists baxwayisa iziguli zabo ukuthi zikhethe umthamo ofanele wesidakamizwa ngokuya ngekhilogremu ngayinye yesisindo sesiguli engu-0,2 iyadingeka. Faka i-insal insulin kanye ngosuku, uma kunesidingo, ulungisa umthamo ohlangothini olulodwa noma kolunye.
Iziguli eziningi ezinesifo sikashukela azazi ukuthi zingashintsha kanjani zisebenzisa iLantus ziye eTujeo. Ngaphandle kokuthi yonke le mishanguzo isuselwa ku-glargine, ayisiyi-bioequivalent futhi ngakho-ke ayithathwa njengengaguquguqukayo.
Ekuqaleni, isiguli sinconywa ukuba sidlulisele umthamo we-insulin eyodwa ye-insulin uye kwesinye ngesilinganiso seyunithi kuya kuyunithi. Kodwa-ke, ngosuku lokuqala ukusetshenziswa kweTujeo, isiguli sidinga ukubheka ngokucophelela izinga le-glucose emzimbeni. Kungenzeka ukuthi ukufinyelela izinga likashukela wegazi elifunekayo, isiguli sizodinga ukwandisa umthamo walesi sidakamizwa.
Ukushintshwa kusuka kokunye ukufakwa kwe-basal kulungiselelwa kweTujeo kudinga ukulungiswa okungathi sína, ngoba kulokhu, umthamo kufanele ungashintshwa hhayi kuphela ngokufaka insulin isikhathi eside, kepha nalabo abasebenza isikhathi esifushane. Futhi ezigulini ezinesifo sikashukela sohlobo 2, umthamo wama-hypoglycemic agents nawo kufanele uguqulwe.
- Inguquko kusuka ekuhambeni kwesikhathi kwe-insulin. Kulesi simo, isiguli singase singaguquki umthamo, sishiye sinjalo. Uma ngokuzayo isiguli siphawula ukwanda koshukela noma, okuphambene nalokho, izimpawu ze-hypoglycemia, umthamo kumele ulungiswe.
- Ushintsho oluvela kuma-insulin aphakathi nendawo. Ama-insalin ase-Medial abamba insulin afakwa emzimbeni wesiguli kabili ngosuku, umehluko wawo obalulekile ovela kuTujeo. Ukuze ubale kahle umthamo womuthi omusha, kuyadingeka ukufingqa lonke ivolumu le-insal insulin ngosuku bese ukhipha cishe ama-20% kuyo. Ama-80% asele azoba umthamo ofanele kakhulu we-insulin ende.
Kumele kugcizelelwe ukuthi umuthi kaTujeo wenqatshelwe ngokuphelele ukuxubana namanye ama-insulin noma ucoce ngento ethile, ngoba lokhu kunganciphisa ubude besikhathi sayo futhi kubangele ukuhanjiswa kwemvula.
Indlela yokusebenzisa
IToujeo yenzelwe kuphela ukufakwa ezicutshini ezingaphansi esiswini, emathangeni nasezingalweni. Kubalulekile ukuthi ushintshe indawo yomjovo nsuku zonke ukuvikela ukungena nokuqalwa kwe-hyper- noma hypotrophy yezicubu ezingaphansi.
Ukwethulwa kwe-insulin insulin eseTujeo emthanjeni kufanele kugwenywe, ngoba lokhu kungadala ukuhlaselwa kanzima kwe-hypoglycemia. Umphumela wesikhathi eside wesidakamizwa uphikelela ngomjovo wangaphansi. Ngaphezu kwalokho, umuthi iTujeo awunakufakwa emzimbeni ngepompo le-insulin.
Ngokusebenzisa ipeni elilodwa lesirinji, isiguli sizokwazi ukuzijova ngomthamo wamayunithi ama-1 kuye kwangama-80. Ngaphezu kwalokho, ngesikhathi sokusetshenziswa kwayo, isiguli sinethuba lokwandisa umthamo we-insulin ngeyunithi elilodwa ngasikhathi.
Imithetho yokusebenzisa ipeni lesirinji:
- Ipeni lesirinji lifakwe imitha yemithamo ekhombisa isiguli ukuthi mangaki amayunithi e-insulin azofakwa phakathi komjovo. Le peni yesirinji yenzelwe ngqo i-Tujeo insulin, ngakho-ke, lapho uyisebenzisa, asikho isidingo sokwenza ukulandisa okungaphezulu komthamo;
- Kuyadikibala ukungena ngaphakathi kwegabriak usebenzisa isirinji ejwayelekile futhi sithathe isisombululo sikaTujeo kuyo. Ngokusebenzisa isirinji ejwayelekile, isiguli ngeke sikwazi ukunquma kahle umthamo we-insulin, ongaholela ku-hypoglycemia enzima.
- Kwenqatshelwe ngokuphelele ukusebenzisa inalithi efanayo kabili. Lapho ulungiselela injekishini ye-insulin, isiguli kufanele sibuyisele inalithi endala ngesiga esisha esisha. Izinaliti ze-insulin zincane kakhulu, ngakho-ke lapho uzisebenzisa futhi, ingozi yokuxhuma kwenaliti iphezulu kakhulu. Kulokhu, isiguli singathola encane kakhulu noma okuphambene nalokho isilinganiso esikhulu se-insulin. Ngaphezu kwalokho, ukusetshenziswa kwenaliti okuqhubekayo kungaholela ekuthelelekeni kwenxeba kusuka kumjovo.
Ipeni lesirinji lenzelwe ukusetshenziswa yisiguli esisodwa kuphela. Ukusetshenziswa kwayo kweziguli eziningana ngasikhathi sinye kungadala ukutheleleka ngezifo eziyingozi ezidluliswa ngegazi.
Ngemuva komjovo wokuqala, isiguli singasebenzisa ipeni lesirinji leTujeo ukujova amanye amasonto ama-4. Kubalulekile ukuyigcina njalo endaweni emnyama, ivikelwe kahle elangeni.
Ukuze ungakhohlwa usuku lomjovo wokuqala, kuyadingeka ukulubonisa emzimbeni wepeni yesirinji.
Izindleko
IToujeo basal insulin isanda kuvunywa eRussia ngoJulayi 2016. Ngakho-ke, ayikakatholi ukusakazwa okubanzi ezweni lethu njengezinye izivakashi ezisebenza isikhathi eside.
Intengo ephakathi yeTujeo eRussia icishe ibe ngama-ruble ayi-3,000. Izindleko eziphansi cishe zingama-ruble angama-2800, kuyilapho esiphezulu singafinyelela kuma-ruble angama-3200.
Ama-Analog
Enye i-insal insulin yesizukulwane esisha ingabhekwa njengezifanekiselo zomuthi weTujeo. Enye yalezi zidakamizwa iTresiba, eyadalwa ngesisekelo se-insulin Degludec. I-Degludek inezindawo ezifanayo ku-Glargin 300.
Futhi, umphumela ofanayo emzimbeni wesiguli ukhishwa yi-insulin peglizpro, ngesisekelo lapho izidakamizwa eziningana zeziguli ezinesifo sikashukela zakhiwa khona namuhla. Ividiyo ekulesi sihloko izokusiza ukuthola ukuthi kunqunywe nini i-insulin.
