I-insulin ingenye yama-hormone abalulekile emzimbeni womuntu. I-insulin ikhiqizwa kuma-pancreas futhi inomthelela ohlukahlukene ezinqubweni ze-metabolic ezicutshini zomzimba.Inhloso eyinhloko yalesi sakhi se-biioactive ukunciphisa ukuhlukunyezwa koshukela emzimbeni.
Ngokuphulwa komkhiqizo we-insulin, umuntu uba nesifo esibizwa ngokuthi yi-mellitus sikashukela. Njengomphumela wentuthuko yalokhu kugula, kukhona ukwephulwa kwezinqubo ze-carbohydrate metabolism.
Abantu abanesifo sikashukela babhekene neqiniso lokuthi izinga le-insulin emzimbeni kufanele ligcinwe ngendlela yokwenziwa. Inani le-insulin elethwe emzimbeni lixhomeke umehluko phakathi kwe-insulin ekhiqizwa umzimba nenani le-insulin elifunwa ngumzimba ukuze lisebenze ngokujwayelekile. Amalungiselelo e-insulin akhona ahlukaniswe izinhlobo eziningi ngokuya ngejubane lokusebenza nesikhathi ubude besenzo somuthi emzimbeni. Olunye uhlobo i-insulin esebenza isikhathi eside.
I-insulin ehlala isikhathi eside iba nomphumela wesikhathi eside ngenxa yale mpahla, lolu hlobo lomuthi lubizwa ngokuthi yi-insulin ende. Lolu hlobo lwama-hormone okufakelwa adlala indima ye-main base hormone eyakha isizinda se-insulin esidingekayo emzimbeni wesiguli.
Izidakamizwa zalolu hlobo ziyakwazi ukuqongelela i-insulin emzimbeni usuku lonke. Emini, kwanele ukufeza imijovo eyi-1-2 ukujwayeza i-hormone egazini. Kancane kancane, ukusetshenziswa kwe-insulin esebenza isikhathi eside kubangela ukuguquguquka kwamazinga e-hormonal emzimbeni. Umphumela utholakala ngosuku lwesibili noma lwesithathu, kufanele kuqashelwe ukuthi umphumela omkhulu utholakala ngemuva kwezinsuku ezingama-2-3, umuthi uqala ukusebenza emahoreni ambalwa.
Amalungiselelo we-insulin ajwayelekile kakhulu asebenza ngale ndlela alandelayo:
- I-Insulin Monodar Long;
- Insulin Ultralong;
- I-Insulin Lantus.
Phakathi kwezidakamizwa ezisebenza isikhathi eside, lokho okubizwa ngamalungiselelo we-insulin okungenasisekelo. Lolu hlobo lwe-insulin lapho lungeniswa emzimbeni alunayo inani eliphakeme lesenzo. Umphumela walezi zidakamizwa emzimbeni ubushelelezi futhi mnene. Izidakamizwa ezidume kakhulu zaleli qembu nguLevemir noLantus.
Zonke izinhlobo ze-insulin zilawulwa ngokungaxhamazeli futhi isikhathi ngasinye indawo yokulawulwa komthamo we-insulin kufanele iguqulwe. Ukulungiselela kwe-insulin akufanele kuhlanganiswe futhi kuxutshwe.
Ngaphambi kokukhetha insulin esebenza isikhathi eside, kufanele ufunde imininingwane yokuthi kwenzekani kulolu hlobo lwe-insulin. Ngaphezu kwalokho, kufanele ufunde imininingwane echazwe kwimiyalo yokusebenzisa futhi uthintane nodokotela we-endocrinologist.
Udokotela akufanele nje abale umthamo womuthi, kodwa futhi ahlakulele nohlelo lokujova.
Kuze kube manje, izinhlobo ezimbili zama-insulin ezinwetshiwe zisetshenziselwa ukwelapha lesi sifo:
- Kufakwa isikhathi sokusebenza kuze kube ngamahora ayi-16;
- Ama-insrain ama-Ultra ahlala isikhathi esingaphezu kwamahora ayi-16.
Iqembu lokuqala le-insulin lifaka:
- UGensulin N.
- I-Biosulin N.
- Isuman NM.
- I-Insuman Bazal.
- I-Protafan NM.
- I-Humulin NPH.
Iqembu le-insulin elenza isikhathi eside lifaka:
- ITresiba KUSHA.
- I-Levemir.
- I-Lantus.
Ama-insral ama-Ultralong awanalutho. Lapho ubala umthamo womjovo nomuthi osebenza isikhathi eside, lesi sici kufanele sibhekwe. Imithetho yokukhetha esele isebenza ejwayelekile kuzo zonke izinhlobo ze-insulin.
Lapho ubala umthamo womjovo owodwa we-insulin ungene emzimbeni, inkomba kufanele ibe njalo ukuthi ukugxila kwe-glucose ngaso sonke isikhathi phakathi kwemijovo kuhlala kusesilinganisweni esifanayo phakathi kwemikhawulo ejwayelekile. Ukuguquguquka okuvumelekile akufanele ngalesi sikhathi akufanele kudlule i-1-1.5 mmol / L.
Lapho wenza isinqumo esifanele se-insulin umthamo, ukugcwala kweglucose egazini kuzinze.
Kuyenqatshelwa ukusebenzisa imishanguzo equkethe i-insulin, impilo yeshelufu yayo ephelelwe yisikhathi. Ehlelweni lokugcina izidakamizwa, kuyadingeka ukubheka izimo zokugcina nokuphila eshalofini kwemithi. Ukusetshenziswa kwe-insulin ephelelwe isikhathi ekwelashweni kungavusa ukujuluka okuthe xaxa, ubuthakathaka, ukwethuka, ukuqunjelwa, futhi kwezinye izimo ngisho nokukhubazeka emzimbeni wesiguli.
Ukulungiswa kwe-insulin yesikhathi eside esebenza kungathathwa hhayi ngomjovo kuphela, kepha nangokuphathwa komlomo umuthi ngesikhathi sokudla.
Ukuphathwa ngomlomo kwalesi sidakamizwa intuthuko ethembisayo, eklanyelwe ukwenza lula impilo yomuntu onesifo sikashukela.
I-insulin esebenza isikhathi eside ikhiqizwa imboni yezemithi ngezindlela ezimbili ngesimo sokumiswa noma isixazululo somjovo.
I-insulin inikezela ukwehla kwesibalo se-glucose emzimbeni ngokuthuthukisa ukumuncwa kwayo ngamaseli emisipha kanye nesibindi, kuthinta izinga lokuhlanganiswa kwezakhi zamaphrotheni, ukusheshisa, kunciphisa ukukhiqizwa kwe-glucose ngama-hepatocytes.
Ngokubalwa okufanele kwevolumu ye-insulin enesikhathi eside isebenza, ukusebenza kwayo kwenzeka ngemuva kwamahora ama-4 ngemuva kokuphathwa kwayo. Inani eliphakeme lokusebenza lenzeka ngemuva kwamahora angama-8 ukuya kwe-20 ngemuva kokuthi umuthi ungene emzimbeni. Isikhathi somsebenzi esiphakeme kakhulu sincike ezicini zomzimba wesiguli kanye nenani lomjovo. Isenzo se-insulin siyaphela emzimbeni amahora angama-28 ngemuva kokuphathwa kwawo. Esimweni sokuphambuka kusuka kulezi zinhlaka zesikhathi, lokhu kungakhombisa ukuba khona kwezimo ze-pathological emzimbeni wesiguli. Futhi lapha kuyadingeka ukuba ube nombono walokho okulimazayo i-insulin kushukela.
Ukuphathwa okucatshangelwa isidakamizwa kuvumela ukuthi i-hormone ibe sezicubu ezinamafutha isikhathi esithile, evumela ukuthi inciphise ukungena kwayo ukungena egazini.
Izinkomba zokusetshenziswa kwe-insulin esebenza isikhathi eside yilezi:
- Isiguli sinesifo sikashukela sohlobo 1.
- Isiguli sinesifo sikashukela sohlobo 2.
- Ukungavikeleki kwesiguli emithini yomlomo eklanyelwe ukwehlisa amazinga kashukela egazini.
- Sebenzisa njengengxenye yokwelashwa okuyinkimbinkimbi.
- Kwenziwa ukungenelela kokuhlinzwa.
- Ukuba khona kwesifo sikashukela sokukhulelwa kwabesifazane abakhulelwe.
Umthamo we-hormone esetshenzisiwe unqunywa yi-endocrinologist ngawodwana futhi unaka zonke izici zomzimba womuntu ogulayo. Umthamo ungabalwa yi-endocrinologist kuphela ngemuva kokuthola imiphumela yokuhlolwa okuphelele kwesiguli nokuthola izivivinyo zelebhu.
Ukusabalalisa i-vial nge-insulin kuvinjelwe ngaphambi komjovo. Ngaphambi kokwethulwa komuthi, kudingekile kuphela ukupheqa ibhodlela eline-insulin entendeni yesandla sakho, lokhu kuzokuvumela ukwakheka okungahambi kahle kwakhiwe futhi ngasikhathi sinye kuvume ukuthi ufudumele umuthi ngaphambi komjovo.
Lapho isiguli sishintsha sisuka ku-insulin yezilwane sisiya kubantu, umthamo kufanele ubalwe kabusha.
Endabeni yokudlulisa isiguli sisuka kolunye uhlobo lomuthi siye kolunye, kuyadingeka futhi ukuguqula umthamo owamukelwe we-insulin.
Elinye lamalungiselelo e-insulin ajwayelekile osebenza isikhathi eside nguDigludek. Lesi sidakamizwa sinomphumela omude ongeziwe. Kuyi-analogue ye-insulin yabantu. Umenzi walesi sidakamizwa yinkampani yaseDenmark uNovo Nordisk.
Isenzo salo muthi sisuselwa ekusetshenzisweni okwengeziwe kwe-glucose kusuka ku-plasma yegazi ngamaseli wamafutha namaseli izicubu zomzimba.
Le nqubo icushiwe ngokufakwa kwehomoni kuma-cell receptors. Umphumela wesibili wezidakamizwa ukuvimba ukukhiqizwa kwe-glucose ngamangqamuzana esibindi, okunciphisa inani le-glucose emzimbeni wesiguli.
Isikhathi salo muthi singaphezu kwamahora angama-42. Iqoqo eliphezulu kakhulu le-insulin emzimbeni litholakala amahora angama-24 kuya kokugcina ngemuva kokulawula umuthi.
Umuthi i-Insulin-glargine ukhiqizwa yinkampani yaseFrance iSanori-Aventis. Ukwenziwa kwalo muthi kufaka i-insulin-glargine, m-cresol, i-zinc chloride, glycerol, sodium hydroxide, amanzi omjovo asetshenziswa njengezakhi ezisizayo ekwakhiweni kwomuthi.
Le ndlela yesidakamizwa iyi-analogue ye-insulin yabantu.
Ngokufakwa komuthi kanye ngosuku, ukuqina okuhlanganisiwe kwekhambi emzimbeni wesiguli kubhekwa izinsuku ezimbili kuya kwezine emva kwenqubo yokuphatha.
Ukuba nesikhathi eside sokwenza umuthi, kukuvumela ukuthi usisebenzise ngosuku kanye kuphela. Ngemuva komjovo, umuthi uqala ihora elilodwa ngemuva komjovo.
Umuthi uvunyelwe ukusetshenziswa kuphela ngomjovo ongaphansi. Umuthi ufakwa emafutheni angaphansi kwesisu ehlombe noma ethangeni.
Imiphumela emibi yokusebenzisa lesi sidakamizwa ukuthuthukiswa kwe-lipodystrophy kanye nokubambezeleka kokufakwa kwe-insulin.
I-Contraindication ongayisebenzisa ukuba khona kwe-hypersensitivity kuya ku-insulin-glargine noma yiziphi izingxenye zemithi. Ngaphezu kwalokho, lesi sidakamizwa asikwazi ukusetshenziselwa izingane ezingaphansi kweminyaka engu-6.
Umuthi uHumulin L uyithuluzi lokwelashwa, inkampani yaseMelika u-Eli-Lilly. Umenzeli ukumiswa oyinyumba kwe-insulin ye-insulin yabantu. Umuthi unomphumela ohlala njalo.
Kwividiyo ekulesi sihloko, udokotela uzoqhubeka nokuveza isihloko se-insulin ende.
