I-insulin yabanesifo sikashukela sohlobo lokuqala, futhi kuyaqabukela kwesesibili, isidakamizwa esibalulekile. Ingena esikhundleni se-insulin yehomoni, okumele i-pancreas ikhiqize ngenani elithile.
Kaningi, iziguli zinikezwa i-insulin emfushane kuphela ne-ultrashort, imijovo leyo enikezwa ngemuva kokudla. Kodwa futhi kuyenzeka ukuthi i-insulin esebenza isikhathi eside iyadingeka, enezidingo ezithile zesikhathi somjovo.
Ngezansi sizocubungula amagama okuhweba ama-insulin ngokusebenza isikhathi eside, impahla yawo yemithi namacala uma imijovo yawo idingeka, kanye nokuphendula kwabanesifo sikashukela ngokusetshenziswa kwe-insulin esebenza isikhathi eside.
I-insulin esebenza isikhathi eside
Ama-diabetesics ohlobo lokuqala anqunywa ama-insulin asebenza isikhathi eside njenge-insal insulin, futhi ohlotsheni lwesibili njenge-mono-therapy. Umqondo we-basal insulin usho insulin, okumele ikhiqizwe emzimbeni phakathi nosuku, ngaphandle kokudla. Kepha ngesifo sikashukela sohlobo 1, akuzona zonke iziguli ezinama-pancreas ezingakhiqiza le-hormone ngisho nakwezilinganisweni ezincane.
Kunoma yikuphi, ukwelashwa kohlobo lwe-1 kuhlanganiswa ngama-insulin amafushane noma e-ultra-iDemo. Imijovo ye-insulin esebenza isikhathi eside yenziwa ekuseni esiswini esingenalutho, kanye ngosuku, ngaphansi kwesibili. Umuthi uqala ukusebenza ngemuva kwehora elilodwa kuya kwamathathu, usebenza kusuka emahoreni ayi-12 kuye kwangama-24.
Amacala lapho kudingeka ukunquma i-insulin esebenza isikhathi eside:
- ukucindezelwa kokusa kokusa kokusa;
- ukuzinza ushukela wegazi ekuseni esiswini esingenalutho;
- ukwelashwa kohlobo lwesibili sikashukela, ukuvikela ukuguquguquka kwalo kuhlobo lokuqala;
- kuhlobo lokuqala lwesifo sikashukela, ukugwema i-ketoacidosis kanye nokugcinwa kokuthile kweseli le-beta.
Ama-insulin angaphezulu kwesikhathi eside ayebekelwe umkhawulo ekukhetheni, iziguli zazinqunyelwe i-NPH-insulin ebizwa ngokuthi i-Protofan. Inombala wamafu, futhi ngaphambi kokujova ibhodlela bekufanele linyakaziswe. Okwamanje, umphakathi we-endocrinologists ukhombise ngokweqiniso iqiniso lokuthi iProtofan inomthelela omubi emasosheni omzimba, ukuwukhuthaza ukuthi ukhiqize ama-antibodies ku-insulin.
Konke lokhu kuholela ekuthini ukungena kwama-insulin antibodies, akwenze kungasebenzi. Futhi, i-insulin eboshiwe ingasebenza kakhulu lapho lokhu kungasadingeki. Lokhu kusabela kungenzeka kakhulu ukuba nomlingiswa ophinyiselwe buthaka futhi kufaka ukugxuma okuncane kushukela, ngaphakathi kwe-2-3 mmol / L.
Lokhu akuzwakali ikakhulukazi yisiguli, kepha, ngokuvamile, isithombe somtholampilo siba sibi. Muva nje, kuye kwenziwa ezinye izidakamizwa ezingenawo umthelela onjalo emzimbeni wesiguli. Ama-Analog
- ILantus;
- I-Levemir.
Anombala obonakalayo, awudingi ukuthuthumela ngaphambi komjovo. I-anulin ye-insulin esebenza isikhathi eside ingathengwa kalula kunoma iyiphi ikhemisi.
Intengo ephakathi yeLantus kwiRussian Federation isukela kuma-ruble angama-3335 - angama-3650, kanye ne-Protofan - ama-ruble ayi-890-970. Ukubuyekezwa kwabanesifo sikashukela kubonisa ukuthi iLantus inomphumela ofanayo kushukela wegazi usuku lonke.
Ngaphambi kokunquma i-insulin esebenza isikhathi eside, i-endocrinologist iyadingeka ukuthi idinge isiguli ukuthi siqophe ngokulawula ushukela wegazi, okwenziwa kusukela ngeviki elilodwa kuya kwamathathu nsuku zonke. Lokhu kuzokhombisa isithombe esiphelele sokuxhuma kweglucose yegazi kanye nesidingo, noma sokukhanselwa kokuqokwa kwalolu hlobo lwe-insulin.
Uma udokotela ekucacisa umuthi ngaphandle kokubheka isithombe somtholampilo sezinga likashukela wegazi, kungcono ukuthi uthintane nelinye i-endocrinologist.
Umshini wokusebenza kwe-insulin ende
Izidakamizwa ezisebenza isikhathi eside zihlanganisa amalungiselelo e-insulin aphakathi nendawo nokuhlala isikhathi eside. Ngaphezu kwalokho, abokuqala baqala ukusebenza emzimbeni ngaphakathi kwehora elilodwa - amahora amabili, bafinyelela inani eliphakeme amahora angama-4 - 11, ubude besikhathi sonke samahora ayi-9 - 12.
Imithi yesikhathi esiphakathi idonswa kancane, futhi ibe nomphumela omude. Lokhu kutholakala ngokubonga kwi-prolongator ekhethekile - i-protamine noma i-zinc. I-NPH-insulin ifaka ekwakhiweni kwayo kweprotamine etholakala kubisi lwezinhlanzi kwisilinganiso se-stoichiometric ratio.
Emakethe yamakhemikhali yesifo sikashukela, amalungiselelo we-insulin anjalo wesikhathi esiphakathi alethwa:
- I-insulin yobunjiniyela bofuzo, amagama okuhweba uProtafan XM, uHumulin NPH, uBiosulin, uGansulin.
- I-insulin yokwenziwa komuntu - uHumador, Biogulin.
- Ingulube yengxenye ye-insulin - I-Protafan MS;
- I-insulin ekumisweni okuyinkimbinkimbi - IMonotard MS.
Umuthi osebenza isikhathi eside uqala umsebenzi wawo kungakapheli amahora ayi-1.5 ngemuva komjovo, ubude bawo buphakathi kwamahora angama-20 - 28. Ngaphezu kwalokho, izidakamizwa ezinjalo zisabalalisa i-insulin emzimbeni wesiguli ngokulinganayo, ezothuthukisa isithombe sezempilo futhi zingabangeli izinguquko ezivamisileko ekujuleni kwenalithi yomjovo we-insulin emfushane ne-Ultra-iDemo.
Izidakamizwa ezisebenza isikhathi eside zifaka i-insulin glargine, efana ne-insulin yabantu. Awunawo umsebenzi wento ephakeme, ngoba ukhishwa ungene egazini ngesilinganiso esifanelekile njalo. I-Glargin ine-acid pH esele. Lokhu akufaki ukuphathwa kwayo okuhlangene ngama-insulin amafushane nama-ultrashort, ngoba le mishanguzo ine-pH yokungathathi hlangothi.
Le mishanguzo ye-insulin ivame ukutholakala ngokumiswa futhi iphathwe ngokungaziphathi kahle noma nge-intramuscularly. Amagama Wokuhweba:
- Insulin Glargine Lantus.
- I-insulin detemir
Kukhona ukuphikisana okunjalo kwemijovo ye-insulin glargine kanye ne-detemir - ikhefu likashukela, pre-coma.
Ngezansi kunemiyalo eningiliziwe yokusetshenziswa kwe-insulin Lantus.
Imiyalo yokusebenzisa umuthi
I-Lantus Solostar 1 ml iqukethe i-insulin glargine engamaphesenti ama-3.63 mg, okulingana ne-100 IU ye-insulin yabantu.
Kuhlanganiswa futhi okukhona: i-glycerol, i-zinc chloride, i-sodium hydroxide, amanzi wokujova.
Ngokubukeka, kuyinto ewuketshezi olungacacile, olungenamibala wokufaka umjovo ongaphakathi ezicutshini ze-adipose zesiguli. Umuthi unezindlela eziningana zokukhishwa:
- Uhlelo lwe-OpticClick, olufaka ama-cartridge ama-3 ml. Ama-cartridge amahlanu kwiphakheji elilodwa.
- 3 ml OptiSet Syringe Pens Lapho i-insulin isiphelile, udinga nje ukuthenga ibhokisi elisha bese ulifaka esibayeni se-syringe. Kwiphakheji elilodwa lekhadibhodi, amapeni ezinhlanu zesirinji.
- I-Lantus Solotar, ama-cartridge ama-3 ml. Afakwe ngokwezifiso esibayeni se-syringe ukuze asetshenziswe kanye, ama-cartridges awathathelwa indawo. Kwiphakheji elilodwa lekhadibhodi, amapeni amahlanu wesirinji, ngaphandle kwenaliti yomjovo.
I-Lantus isidakamizwa okuyiqembu le-pharmacotherapeutic lezidakamizwa ze-antidiabetes. Into esebenzayo kaLantus - i-insulin glargine iyi-analogue yesenzo sabantu se-insulin. Kuhlakazwa ngokuphelele egazini. Isenzo se-insulin senzeka ngokushesha.
Umuthi unomphumela onjalo emzimbeni wesiguli:
- Yehlisa ushukela wegazi.
- Kukhulisa ukuthathwa kwe-glucose kanye nokusetshenziswa kwemisipha yamathambo kanye nezicubu ze-adipose.
- Ivuselela i-biotransformation ye-glucose ibe yi-glycogen esibindini.
- Ezicubu zemisipha, kwandisa ukukhiqizwa kwamaprotheni.
- Kwandisa ukukhiqizwa kwe-lipid.
Kunconywa ukwenza imijovo kanye ngosuku, yi-endocrinologist kuphela ebeka umthamo, kucatshangelwa ubunzima besifo. Ezigulini ezinoshukela ofanayo wegazi, imithamo ingahluka, ngenxa yemiphumela ehlukene emzimbeni wesiguli kanye nokuqunjelwa kwabo ngokomzimba.
ILantus inqunyelwe kuphela isifo sikashukela sohlobo lokuqala nesesibili, kubantu abadala nasezinganeni ezineminyaka engaphezu kweyisithupha. Ukusebenza kwomuthi akuhloliswanga izingane ezingaphansi kweminyaka eyisithupha.
Imiphumela emibi ye-insulin ibonakala ikakhulu esimweni sokuqokwa komthamo ongalungile. Okusemqoka yile:
- I-Hypoglycemia
- I-Neuroglycopenia
- Isimiso esiphikisayo se-Adrenergic.
Ukusabela kwe-allergic ngendlela yokumiswa, ukuvutha kanye ne-urticaria endaweni yomjovo nakho kungaba. Lolu phawu lwendawo luhlala isikhathi esingafika ezinsukwini eziyisikhombisa bese lunyamalala lodwa.
Imiyalo ekhethekile: umuthi akufanele uhlanganiswe nezinye izinhlobo ze-insulin, ngoba iLantus inemvelo ye-pH ene-acid. Imijovo kufanele inikezwe ngasikhathi sinye sosuku, ngaphandle kokudla. Ividiyo ekulesi sihloko ikutshela ukuthi ngubani onqunywe i-insulin.
