Iziguli eziningi ezinesifo sikashukela zinomdla embuzweni wokuthi iyiphi i-insulin analogue esetshenziswa kangcono ukwehlisa ushukela wegazi.
Namuhla, uhlobo olunjalo lokwelashwa lithandwa kakhulu. Lokhu kungenxa yezinto ezifana:
- I-insulin yezimboni ikhombisa ukusebenza kahle kakhulu.
- Izidakamizwa ezinjalo ziphephile impela.
- Zilula kakhulu ukusebenzisa.
Izidakamizwa zesimanje zikuvumela ukuthi ushintshe umthamo ngokuya ngezinguquko ekusekelweni kwe-hormone ngumzimba uqobo.
Okufanelekile ikakhulukazi ngumbuzo wokuthi yiziphi i-insulin analogues ekwelapheni i-mellitus yesifo sikashukela ezikhethwe kahle kulezi ziguli ezinenkinga yesifo sikashukela sohlobo 2 manje. Iningi leziguli liyaziwa ukuthi lisuka kwelinye iphilisi liye kumjovo. Ngakho-ke, kubaluleke kakhulu ukukhetha umuthi wanamuhla futhi osebenza kakhulu ngomjovo.
Ukubuyiselwa okungenzeka kwe-insulin kulezo ziguli esevele zithatha imijovo yalesi sidakamizwa. Imvamisa lokhu kwenzeka lapho ukwelashwa kwenziwa nomuthi osuphelelwe yisikhathi. Ngenxa yalokho, imiphumela emibi efana:
- Ukulahleka okubukhali kombono.
- Ukonakala kwazo zonke izitho zangaphakathi.
- Ukugxuma okuvama ushukela wegazi, okuholela ekukhuleni kwe-hypoglycemia noma i-hyperglycemia.
Kepha, ngeqiniso, udokotela kuphela ongenza ukuqokwa okunjalo, kufanele asihlole ngokugcwele isiguli futhi athole ukuthi ngabe kukhona yini okuphula umthetho ku-analogue ethile ye-insulin.
Uyini umehluko phakathi kwezidakamizwa?
Enye yezindlela eziphambili lapho ukhetha i-analogues yabantu ye-insulin yinto efana nesivinini somphumela wayo emzimbeni. Isibonelo, kukhona lezo ezenza ngokushesha okukhulu futhi umjovo kufanele wenziwe imizuzu engamashumi amathathu noma engamashumi amane ngaphambi kokudla. Kepha kukhona labo, ngaphandle kwalokho, abanomphumela omude kakhulu, lesi sikhathi singafinyelela amahora ayishumi nambili. Endabeni yokugcina, le ndlela yokusebenza ingadala ukukhula kwe-hypoglycemia ku-mellitus yesifo sikashukela.
Cishe wonke ama-analog anamuhla we-insulin enza ngokushesha. Okuthandwa kakhulu yi-insulin yomdabu, isebenza ngomzuzu wesine noma wesihlanu ngemuva komjovo.
Ngokuvamile, kuyadingeka ukugqamisa izinzuzo ezilandelayo zezifanekiselo zesimanje:
- Izisombululo ezingathathi hlangothi.
- Umuthi utholakala ngokusebenzisa ubuchwepheshe besimanjemanje be-DNA.
- I-anulinue yesimanje yanamuhla inezinto ezintsha zokwelapha.
Ngenxa yazo zonke lezi zakhiwo ezingenhla, kungenzeka ukuba uzuze ibhalansi ephelele phakathi kwengozi yokuthuthukisa i-spikes engazelelwe emazingeni kashukela futhi uthole izinkomba ze-glycemic ezihlosiwe.
Izidakamizwa zesimanje ezaziwa kakhulu zingabonakala:
- I-analog ye-insulin ye-ultrashort, okuyi-Apidra, Humalog, Novorapid.
- Kuqhubeka - Levemir, Lantus.
Uma isiguli sinemiphumela emibi ngemuva kwemijovo, udokotela uphakamisa ukuthi ungene esikhundleni se-insulin.
Kepha udinga ukwenza lokhu kuphela ngaphansi kokuqashwa kongcweti futhi ubheke inhlala-kahle yenhliziyo yesiguli ngesikhathi senqubo yokumiselela.
Izici zeHumalog (lispro noxube 25)
Lesi ngesinye se-insulins esidume kakhulu - ama-analogues ehomoni yomuntu. Ubuntu bayo bungamaqiniso wokuthi bangeniswa ngokushesha egazini lomuntu.
Kuyaqapheleka futhi ukuthi uma uyijova nge-frequency ethile futhi kuthamo elilinganayo, khona-ke amahora ama-4 ngemuva komjovo, ukuqoqwa kwe-hormone kuzobuyela ezingeni lakhona lasekuqaleni. Uma kuqhathaniswa ne-insulin ejwayelekile yomuntu, le nkathi imfushane kakhulu njengoba lokhu okugcina kuthatha cishe amahora ayisithupha.
Enye into efaka lesi sikhala se-insulin yabantu ukuthi icatshangelwa ngangokunokwenzeka, ngakho-ke isikhathi sokuzivumelanisa naso sidlula ngaphandle kwezinkinga futhi kulula kakhulu. Isikhathi somuthi asinciki kumthamo. Esikhundleni salokho, noma ngabe ukhulisa umthamo walo muthi, isikhathi sokwenza kwawo siyohlala sinjalo. Futhi lokhu, kunikeza isiqinisekiso sokuthi isiguli asizange sibambezele i-glycemia.
Zonke lezi zici ezingenhla zizenza zifane kakhulu nge-insulin evamile yomuntu.
Ngokuqondene ne-Humalog mix 25, kufanele kuphawulwe lapha ukuthi lokhu kuyingxube yezakhi ezinjengokuthi:
- Isisindo esivelisiwe se-hormone lispro (75%).
- I-Insulin Humalog (25%).
Ngenxa yesakhi sokuqala, lesi sidakamizwa sinesikhathi esifanele kakhulu sokuchayeka emzimbeni. Kuzo zonke izithasiselo ze-insulin ezikhona ze-hormone yomuntu, kunikeza ithuba eliphakeme kakhulu lokuphinda ukwenziwa kwe-basal kwehomoni ngokwayo.
Ama-hormone ahlanganisiwe kwesinye isikhathi anqunyelwa kubantu abahlushwa uhlobo lwesibili lwalesi sifo. Lolu hlu lubandakanya lezo ziguli esezikhulile noma ezinenkinga yememori.
Lokhu kungenxa yokuthi le hormone ingahanjiswa ngokushesha ngaphambi kokudla, noma ngokushesha ngemuva kwayo.
Yini okufanele uyikhethe - i-Apidra, Levemir noma iLantus?
Uma sikhuluma ngehomoni yokuqala, khona-ke esimeni sayo sokwenyama sifana kakhulu neHumalog echazwe ngenhla. Kepha maqondana ne-mitogenic kanye nomsebenzi we-metabolic, ifana ngokuphelele ne-insulin yomuntu. Ngakho-ke, lungasetshenziswa isikhathi esingapheli. Kubalulekile ukuqaphela ukuthi iqala ukusebenza ngokushesha ngemuva komjovo.
Njengasesimweni seHumalog, le analogue ye-insulin yabantu ivame ukukhethwa ngabantu abaneminyaka yobudala. Ngemuva kwakho konke, ingathathwa ngokushesha ngaphambi noma ngemuva kokudla.
Ngokuqondene neLevemir, inesikhathi esiphakathi. Kufanele isetshenziswe kabili ngosuku futhi lapho-ke izokwazi ukugcina ukulawulwa okulungile kwe-basal glycemic usuku lonke.
Kepha uLantus, okuphambene nalokho, usebenza ngokushesha okukhulu. Ngaphezu kwalokho, incibilikisa kahle kakhulu endaweni enomzimba omncane, incibilika endaweni engathathi hlangothi ibi kakhulu. Ngokuvamile, ukusakazwa kwayo kuthatha cishe amahora angamashumi amabili nane. Ngakho-ke, isiguli sinamandla okujova kanye ngosuku. Kubalulekile futhi ukuqaphela ukuthi ingakhonjwa kunoma iyiphi ingxenye yomzimba: isisu, ingalo noma umlenze. Isikhathi esijwayelekile sokusebenza kwe-hormone ngamahora angamashumi amabili nane, bese kuthi phezulu kube ngamashumi amabili nesishiyagalolunye.
ILantus inalezi zinzuzo:
- Zonke izicubu zomzimba ezixhomekeke kwinsulin ziqala ukusebenzisa ushukela kangcono kakhulu.
- Ihlisa kahle ushukela wegazi.
- Ibambezela inqubo yokuhlukanisa amafutha, amaprotheni, ngakho-ke ingozi yokwanda kwezinga le-acetone egazini nomchamo incishisiwe.
- Ngcono imetabolism yazo zonke izicubu zomzimba emzimbeni.
Zonke izifundo ziqinisekisa ukuthi ukusetshenziswa okuvamile kokufaka esikhundleni se-insulin yomuntu kwenza ukuthi sikwazi ukulingisa ngokuphelele ukukhiqizwa okungokwemvelo kwaleli hormone emzimbeni.
Ungenza kanjani ukukhetha okuhle?
Lapho kuphakama umbuzo wokuthi yikuphi okungathatha isikhundla se-insulin emzimbeni, into yokuqala okufanele yenziwe ukwenza ukuhlolwa okugcwele kwesiguli futhi kukhombe zonke izici zenkambo yesifo sikashukela esigulini esithile. Kuyenqatshelwe ngokuphelele ukuthi ushintshe lowo obambele esikhundleni noma ushintshele kumijovo ngemuva kokuthatha amaphilisi ngaphandle kokuvakashela udokotela.
Kungemva kokuhlolwa ngokuphelele, udokotela anganikeza imvume yakhe yokushintsha umuthi noma awunikeze okokuqala.
Ungakhohlwa ukuthi lapho usebenzisa ithuluzi elithile, kuyadingeka ukuthi kwenziwe uhlolo olwengeziwe lwesiguli njalo. Lokhu kumele kwenziwe ukuze kubhekwe ukuthi ngabe kukhona noma iziphi izinguquko ezibukhali zesisindo somzimba wesiguli zenzeka ngenkathi kuthathwa imijovo, uma kuvela ezinye izifo ezihlobene, futhi uma kunengozi ye-hypoglycemia. Ukulandela konke lokhu, isiguli uqobo kufanele sivame ukuvakashela i-endocrinologist yakhe yendawo futhi sicacisa isimo sempilo yayo.
Kodwa ngaphandle kwazo zonke izincomo ezingenhla, usadinga ukunamathela njalo ekudleni okufanele. Futhi phila impilo enempilo. Ukuhamba njalo emoyeni omusha kuzokwenza isimo sibe ngokwejwayelekile, futhi kuzothuthukisa nokukhiqizwa kwe-insulin ye-hormone ngumzimba wesiguli uqobo.
Muva nje, kunezeluleko eziningi ngokukhetha ukudla okufanele nokudla okukhethekile okusiza ukubuyisela ama-pancreas kanye nokwenza ngcono ukukhiqizwa kwehomoni eshiwo ngenhla. Kodwa-ke, ngaphambi kokuqala ukusetshenziswa kwezincomo ezinjalo, kufanele uthintane nodokotela wakho. Ividiyo ekulesi sihloko ikhuluma ngezakhi ze-insulin.
