Ukwelapha i-insulin ngesifo sikashukela, imboni yezemithi ikhiqiza izinhlobo ezahlukahlukene zemithi.
Le mishanguzo ihluka ngezindlela eziningi.
Izici ezihlukanisayo zemithi equkethe i-insulin yile elandelayo:
- umsuka womkhiqizo;
- izinga lokuhlanzwa komuthi;
- inkathi yokusebenza komuthi.
Ehlelweni lokusebenzisa izindlela zokwelapha ekwelapheni isifo sikashukela, kusetshenziswa amasu ahlukile wokuphathwa kwe-insulin emzimbeni wesiguli. Lapho enza uhlobo lokwelashwa, udokotela uyakhombisa:
- uhlobo lwe-insulin esetshenziselwa umjovo;
- isikhathi sokudonswa komuthi emzimbeni wesiguli esinesifo sikashukela;
- umthamo womthamo owodwa womuthi.
Impumelelo yokwelashwa ixhomeke ekugcwalisekeni okuyikho kwazo zonke izidingo lapho kuthuthukiswa inkambo yokwelashwa kwe-insulin.
Ukubalwa kwethamo lomuthi osetshenziswayo lwenziwa yi-endocrinologist eye khona. Lapho ukhetha umthamo womjovo, isikhathi sokulawulwa kwezidakamizwa kanye nohlobo lomuthi osetshenzisiwe, udokotela kufanele acabangele ngayo yonke imiphumela etholakele ngesikhathi kuhlolwa isiguli kanye nezimpawu zomzimba womuntu ohlushwa isifo sikashukela mellitus. Umuntu ngamunye unenkambo yakhe ehlukile yesifo, ngakho-ke azikho izindinganiso ezicacile zokwelashwa.
Lapho udweba irejimusi yokwelashwa usebenzisa i-insulin therapy, izinhlobo eziningana zemithi equkethe i-insulin zingasetshenziswa. Kuhlobo lokwelashwa lungasetshenziswa:
- i-insulin ye-ultrashort;
- izidakamizwa ezithatha isinyathelo esifushane;
- ubude besikhathi esiphakathi;
- insulin okuhlala isikhathi eside;
- amalungiselelo okuba nokwakhiwa okuhlangene.
Enye yezidakamizwa ezivame ukusetshenziswa ezisetshenziselwa ukwakhiwa kwama-insulin therapy regimens ama-insulin asebenza isikhathi eside.
Ukusetshenziswa kwe-insulin isikhathi eside akukwazi ukuvimbela ukweqa ezingeni le-glucose ku-plasma yegazi lesiguli esinesifo sikashukela mellitus. Ngalesi sizathu, lolu hlobo lwesidakamizwa alusetshenziswa uma kunesidingo sokuletha izinkomba ze-glucose emzimbeni wesiguli ezinkomba ezisondele kakhulu esimweni sokuphila.
Lokhu kungenxa yokuthi insulin ezisebenza isikhathi eside zinomthelela omncane emzimbeni womuntu.
Ukwelashwa kwe-insulin isikhathi eside kwesifo sikashukela i-mellitus
I-insulin ende isetshenziswa kulezo zimo lapho kudingekile ukuze kulondolozwe izinga elijwayelekile lomzimba we-insulin kwiplasma yegazi isikhathi eside esiswini esingenalutho.
Ngokusekelwe kwimininingwane etholwe yisiguli ngesikhathi sokuzihlola kanye nedatha etholwe ngesikhathi kuhlolwa umzimba, udokotela unquma ukuthi ngabe kunesidingo sokwethula i-insulin esebenza isikhathi eside emzimbeni ekuseni, ngaphambi kokudla.
Isisekelo sokwakha irejimeni yokwelashwa kwe-insulin sithathwa njengomphumela wokuziqapha ezinsukwini eziyisikhombisa ezedlule. Ngaphezu kwalokho, izimo ezihambisana nalokhu, uma zikhona, zithinteka ekuthuthukisweni kwerejimeni yokwelashwa.
Namuhla, esinye sezidakamizwa ezijwayelekile ezivulekile zokukhishwa nguLevemir noLantus. Lawa ma-ejenti aqukethe i-insulin asetshenziswa ekwelapheni isifo sikashukela sohlobo 1 nohlobo 2. Ukwethulwa kwemithamo yale mishanguzo kwenziwa ngokuya ngesicelo njalo emahoreni ayi-12 noma njalo emahoreni angama-24.
I-insulin ehlala isikhathi eside ingabekwa noma ngabe ithini inqubo yokuphathwa kwezidakamizwa isikhathi esifushane sokwenza. Ukusetshenziswa kwalolu hlobo lwe-insulin kuzimele kwezinye izingxenye zohlu lwe-insulin. Lokhu kungenxa yokuthi iziguli ezinesifo sikashukela i-mellitus zingadinga imijovo yama-insulin ahlukahlukene abe nezikhathi ezihlukile zomsebenzi. Le ndlela yokwelashwa kwe-insulin ivumela ukusetshenziswa kwama-insulin ahlukene ukuze kulondolozwe izinga le-hormone emzimbeni womuntu ngamanani asondele enkambisweni yomzimba, evimbela ukukhula kwezinkinga ezinzima kubantu.
Ukusetshenziswa kwe-insulin ende ku-regimen yokwelashwa kukuvumela ukuthi wenze ukukhiqizwa kwe-insal insulin yi-pancreas, okuvimbela ukukhula kwe-gluconeogeneis emzimbeni. Ngaphezu kwalokho, kusetshenziswa insulin okuhlala isikhathi eside inqubo yokwelashwa kwe-insulin ukuvikela ukufa kwamangqamuzana e-pancreatic abhekene nokuhlanganiswa kwe-hormone yemvelo.
Le ndlela ivumela ngokuzayo, ngenkathi kuqinisa umzimba nazo zonke izinqubo ze-carbohydrate metabolism, ukwenqaba ekwelashweni kwe-insulin.
Ukusetshenziswa kwama-insulin asebenza isikhathi eside ukubuyisa ushukela kubuye kwesejwayelekile
Uma isiguli esinesifo sikashukela sohlobo 2 sikashukela sinezinga likashukela we-plasma ekuseni lapho sifakwa kusihlwa, ngaphambi kokulala nezidakamizwa ezinciphisa ushukela, khona-ke kufanele siphuze imijovo ye-insulin, esebenza isikhathi eside ngaphambi kokulala.
Kodwa ngaphambi kokusebenzisa lezi zinyathelo, udokotela oholayo kufanele aqinisekise ukuthi isiguli asikuthanga ukudla amahora angama-5 ngaphambi kokulala. Uma umuntu onenkinga yokudla ushukela esikhathini esizayo, khona-ke ukusetshenziswa kwemijovo, okubandakanya ukufaka insulin isikhathi eside, ngeke kunikeze umphumela omuhle odingekayo.
Ukwanda kwe-glucose ekuseni kungadalwa nomsebenzi owengeziwe wesibindi ngalesi sikhathi. Lapho amangqamuzana omzimba eqala ukungathathi hlangothi kwe-insulin, okucasulayo ukwanda kwezinga lokuhlushwa ushukela ku-plasma.
Ukuba khona komzimba womuntu womkhuba wokuqalwa kwesibindi kwasekuseni kuholela eqinisweni lokuthi ama-insulin anwebayo kufanele afakwe kumuntu kungakapheli amahora angama-8 ngaphambi kwesikhathi sokuvuka.
Uma amahora ama-4 ngemuva kokuphathwa kwe-insulin, enesikhathi eside sokwenza, ukwehla kwezinga le-glucose elingaphansi kuka-3.5 mmol / l kubonwa, umthamo kufanele uhlukaniswe ngesigamu bese ulawulwa kusihlwa nangemva kwamahora amane.
Ukusetshenziswa kwerejimeni enjalo yokuphathwa kwezidakamizwa kuvumela ukuthi umthamo wayo wehliswe ngo-15% ngemuva kwesikhathi esifushane.
Ukusetshenziswa kwe-insulin esebenza isikhathi eside kuhlobo 2 sikashukela
I-insulin esebenza isikhathi eside ayisetshenziswa njalo ekwelapheni isifo sikashukela sohlobo 2. Kodwa-ke, kwesinye isikhathi kuvela izimo lapho ngaphandle kokusebenzisa izidakamizwa zalolu hlobo kungenakwenzeka ukuguqula izinga likashukela bese kunxephezela umphumela womzimba wesifo.
Ukuze unqume isidingo somjovo, isiguli kufanele ngokushesha silinganise izinga le-glucose emzimbeni ngemuva kokuvuka. Ngemuva kwalokho, phakathi nosuku kufanele wenqabe ukudla ngesikhathi sebhulakufesi nangelantshi, futhi isidlo sakusihlwa kufanele senziwe ngaphambi kwamahora ayi-13 ngemuva kokuvuka. Usuku lonke, isiguli kufanele sisebenzise isilinganiso esikhulu soketshezi ukuze singakhuhli ukuthuthuka komzimba nokuphefumula kwezinkinga.
Ukulinganisa kwesibili kwe-glucose kufanele kwenziwe ngehora elilodwa emva kokuqala bese kuthi njalo ngamahora ama-4 nangaphambi kokudla esidlweni sakusihlwa.
Uma phakathi nosuku izinga le-glucose ku-plasma yegazi lenyuke ngaphezu kwe-0,6 mmol / l futhi lingazange liwele emva kwalokho liye ezingeni eledlule, khona-ke ukwethulwa kwe-insulin kuyadingeka emzimbeni.
Ngaphambi kokusebenzisa umuthi, kufanele ubale inani lawo ngomjovo owodwa.
Ukuhlolwa kabusha ukuze kutholakale amaphutha ekubalweni nasekulungiseni umthamo womuthi osetshenziselwe umjovo akufanele wenziwe kungakapheli isonto elizayo ngenxa yokuthi isiguli esinesifo sikashukela sinokukhuluka kokusebenza lapho sisebenza.
Izinhlobo ze-Insulin ezisebenza isikhathi eside
Kuze kube manje, odokotela basebenzisa izinhlobo ezimbili zamalungiselelo e-insulin asebenza isikhathi eside:
- insulin ende yesikhathi esiphakathi nesikhathi samahora ayi-16;
- I-Ultra-ende, nesikhathi sokuvunyelwa okungaphezu kwamahora ayi-16.
Le mishanguzo elandelayo ibhekwa njengengumugqa wesikhathi eside osebenza okuphakathi:
- I-Protafan NM;
- I-Humulin NPH;
- Biosulin N;
- I-Insuman Bazal;
- UGensulin N.
Amalungiselelo we-Ultra-ende aqukethe i-insulin yile:
- I-Levemir;
- I-Lantus.
Ama-insulin angamalungu eqembu lesibili lezidakamizwa abhekwa njengezindlela eziphumelela kakhulu. Izidakamizwa zeqembu lokuqala zinamafu futhi zidinga ukuyaluza ukuthola isixazululo esifanayo ngaphambi kokuzisebenzisa.
ILantus neLevemir yizidakamizwa ezinomphumela ozinzile, zinomphumela ofanayo kwiziguli ezinaluphi uhlobo lwesifo sikashukela.
Ama-insulin asebenza isikhathi eside ngokwesikhathi somsebenzi anenani eliphakeme, yize leli nani eliphakeme lomsebenzi lingashiwongo ngokuthi, ngokwesibonelo, kwizidakamizwa ezinesikhathi esifushane somsebenzi.
Ngokungafani namalungiselelo amade, amade e-Ultra awanayo i-peak yokusebenza futhi umphumela wawo emzimbeni ungaphezulu futhi ubushelelezi. Lesi sici kufanele sibhekwe lapho kubalwa umthamo wenkambo yokwelashwa kwe-insulin.
Ukubalwa komthamo womuthi owedlule kufanele wenziwe ngendlela yokuthi izinga likashukela emzimbeni wesiguli phakathi kwezikhathi zokudla lihlala ligxilile, futhi uma kwenzeka ukuguquguquka akumele kudlule i-1-1,5 mmol / l. Lapho kubalwa umthamo womuthi ozowusebenzisa, ukuguquguquka okubonakalayo kushukela egazini okuyi-plasma yesiguli esinesifo sikashukela akufanele kuqashelwe amahora angama-24.
Ukufakwa umjovo we-insulin isikhathi eside kwenziwa ethangeni noma emabhulokeni, okunomthelela ekuthini ukuhamba komoya kancane futhi okuthe xaxa kufinyelele egazini.
Awukwazi ukufaka esikhundleni ukusetshenziswa kwe-insulin emfishane ne-ultrashort ngede, ngoba lokhu kuholela ekwakhiweni kwezinkinga ezinzima emzimbeni.
Izici zokusebenzisa i-insulin
Ukudla okwedlulele lapho usebenzisa izinhlobo ezahlukahlukene ze-insulin kuholela eqinisweni lokuthi ubunzima obukhulu buqala ukukhula emzimbeni wesiguli. Lezi zinkinga zingafaka:
- amazinga ahlukahlukene okukhuluphala;
- izinkinga ngokusebenza kohlelo lwe-vascular;
- ukwenzeka kanye nentuthuko ye-atherosulinosis.
Uhlobo ngalunye lwe-insulin lusetshenziselwa kuphela ukwenza imisebenzi eyabelwe ngokuqinile, futhi umsebenzi wesiguli nodokotela ohambayo ukusatshalaliswa okufanele kwemithamo yemithi esetshenziselwa ukwelashwa kwe-insulin.
Indlela efanele yokubala umthamo odingekayo ingaqinisekisa ukwelashwa kwe-insulin ephezulu kakhulu kushukela. Ngaphezu kwalokho, uhlobo lokwelashwa olukhethwe kahle ngalesi sifo luvimbela ukuthuthukiswa kwezinkinga emzimbeni ezibangelwa ukuqhubeka kwesifo sikashukela esibuhlungu. Ividiyo ekulesi sihloko izokutshela ukuthi wenzeni nge-insulin.
