Ukwelashwa kwe-insulin ngesifo sikashukela kunqunywe yi-endocrinologist. I-insulin esetshenziswa ngesikhathi sokwelapha ifinyelela ukubopha okunamandla kwe-glucose eyeqile emzimbeni womuntu ogulayo.
Ukuqokwa kohlobo lwe-insulin therapy regimen akufanele kube okujwayelekile, indlela yomuntu ngamunye kufanele ithathwe esigulini ngasinye, futhi ukuthuthukiswa kohlu lokuphathwa kwe-insulin uqobo lwenziwa ngokwedatha etholwe njengomphumela wokubheka ngokuphelele ushukela wegazi isonto lonke.
Esimweni lapho udokotela ohambelayo, ngenkathi ethuthukisa irekhodi lokwelashwa kwe-insulin, angazinaki izici zomzimba wesiguli nedatha etholakele ngenxa yokuhlola ushukela egazini, kufanele ufune usizo komunye uchwepheshe.
Uhlobo lokulashwa kwe-insulin olunikezwa ngomuthi ongafanele lungasicindezela kakhulu isimo sesiguli kuze kube kuqala izimpawu zokuhluleka kwe-renal nokuphazamiseka ekunikezelweni kwegazi emalungeni.
Uma inqubo yokwelashwa kwe-insulin ithuthukiswa ngaphandle kokucabanga ngezimpawu zomzimba wesiguli, lokhu kungaholela emiphumeleni emibi kuze kube sekukhawulweni kwemikhawulo ngenxa yokuthuthuka kwezinqubo zobugebengu ezicutshini.
Umehluko phakathi kwezinhlobo zokwelapha i-insulin
Ukukhethwa kokwelashwa kwe-insulin kwesifo sikashukela sohlobo 1 kwenziwa yi-endocrinologist ngokuya ngezimpawu zomzimba wesiguli.
Uma isiguli singenazinkinga zokukhuluphala ngokweqile, futhi empilweni azikho izingcindezi zemizwa ngokweqile, khona-ke i-insulin ibekelwa inani leyunithi engu-0.5-1 kanye ngosuku ngosuku lwekhilogremu eyodwa yesisindo somzimba sesiguli.
Kuze kube manje, ama-endocrinologists asungule lezi zinhlobo ezilandelayo zokwelashwa kwe-insulin:
- kuqinisiwe;
- ngokwesiko
- isenzo sokupompa;
- isisekelo sebolus.
Izici zokusetshenziswa kokuqina kwe-insulin
Ukwelashwa kwe-insulin okuqinisiwe kungabizwa ngokuthi yisisekelo sokwelashwa kwe-bolus insulin, ngokuya ngezici ezithile zendlela.
Isici sokwelashwa kwe-insulin okuqinisiwe ukuthi sisebenza njengesixhobo sokugodlwa kwemvelo kwe-insulin emzimbeni wesiguli.
Le ndlela isetshenziswa lapho kudingeka ukwelashwa kwe-insulin yohlobo 1 sikashukela. Ukwelashwa kwalolu hlobo lwesifo lapho ukwelashwa okunjalo kunikeza izinkomba ezihamba phambili zokwelashwa, futhi lokhu kuqinisekiswa ngokomtholampilo.
Ukuqedela umsebenzi kudinga ukufezeka kohlu oluthile lwezimo. Lezi zimo zimi ngokulandelayo:
- I-insulin kumele ifakwe emzimbeni wesiguli inani elanele lokusebenzisa ukusetshenziswa kweglucose.
- Ama-insulin angeniswe emzimbeni kumele afane ngokuphelele nama-insulin akhiqizwa yi-pancreas yesiguli esinesifo sikashukela i-mellitus.
Izidingo ezichaziwe zinquma ubungozi bokwelashwa kwe-insulin okubandakanya ukuhlukaniswa kwezidakamizwa ezisetshenziselwa ama-insulin ezenzo zesikhashana nezinde.
Ama-insulin asebenza isikhathi eside asetshenziselwa ukuphatha i-insulin ekuseni nakusihlwa. Lolu hlobo lwesidakamizwa lulingisa ngokuphelele imikhiqizo ye-hormonal ekhiqizwa ama-pancreas.
Ukusetshenziswa kwama-insulin isikhathi esifushane sokwenza isenzo kunesizathu ngemuva kokudla isidlo esiphakeme kuma-carbohydrate. Umthamo osetshenziselwa ukwethula le mishanguzo emzimbeni uncike kwinani lamayunithi esinkwa aqukethe ekudleni futhi anqunywa ngokuqinile ngawodwana esigulini ngasinye.
Ukusetshenziswa kwe-insulin yokwelashwa okuqinisiwe kwesifo sikashukela sohlobo lwe-1 kubandakanya ukufaka izilinganiso ze-glycemia ngaphambi kokudla.
Izici zokusetshenziswa kwendabuko yokwelapha nge-insulin
Ukwelashwa kwe-insulin yendabuko kuyindlela ehlanganisiwe ehlanganisa ukuhlanganisa isenzo se-insulin esifushane nesesikhathi eside komjovo owodwa.
Inzuzo enkulu yokusebenzisa lolu hlobo lokwelashwa ukunciphisa inani lemijovo lincane. Imvamisa, inani lemijovo ngesikhathi sokwelashwa ngokuya ngale ndlela isukela ku-1 iye ku-3 ngosuku.
Okubi kokusebenzisa le ndlela ukungakwazi ukulingisa ngokuphelele umsebenzi wamanyikwe. Lokhu kuholela eqinisweni lokuthi uma usebenzisa le ndlela akunakwenzeka ukunxephezela ngokuphelele ukwephulwa kwe-carbohydrate metabolism yomuntu.
Ngenqubo yokusebenzisa le ndlela, isiguli sithola imijovo eyi-1-2 ngosuku. Ama-insulin amafushane namade aphathwa kanyekanye emzimbeni. Ama-insulin anesikhathi esimaphakathi sokuvezwa enza cishe i-2/3 yomthamo ophelele wezidakamizwa ezilawulwayo, ingxenye eyodwa kwezintathu yemithamo yansuku zonke iyimishuwalense efushane.
Ukwelashwa kohlobo lwe-1 yesifo sikashukela sohlobo lwendabuko yokwelashwa kwe-insulin akudingi ukukalwa njalo kwe-glycemia ngaphambi kokudla.
Izici zokusetshenziswa kwepampu insulin therapy
Iphampu ye-insulin iyithuluzi elisebenza ngogesi elenzelwe ukuhlinzeka ngokulawulwa kwe-insulin kwansuku zonke kwamalungiselelo we-insulin anesenzo esifushane noma esinqamulelayo.
Lapho usebenzisa lolu hlobo lokwelapha, umuthi ubhalwa ngemithamo emincane.
Uhlelo lwe-insulin pump lwe-elekthronikhi lungenziwa ngezindlela ezahlukahlukene. Izindlela eziyinhloko zokusebenzisa iphampu yilezi ezilandelayo:
- Ukuphathwa okuqhubekayo kwesidakamizwa emzimbeni ngendlela yama-microdoses anesilinganiso esisezingeni eliphansi.
- Ukwethulwa kwalesi sidakamizwa emzimbeni ngesilinganiso se-bolus lapho imvamisa yokujova komuthi ihlelwa yisiguli.
Endabeni yendlela yokuqala yokulawulwa kwe-insulin, ukulingisa okuphelele kokukhululwa kwama-hormone kupancreas kwenzeka. Le ndlela yokulawulwa kwezidakamizwa yenza ukuthi kungasebenzisi i-insulin esebenza isikhathi eside.
Ngokusebenzisa indlela yesibili yokwethula i-insulin emzimbeni kulungisiswa ngaphambi kokudla noma ngezikhathi lapho kunokwenyuka khona kwe-glycemic index.
Isikimu sokwelapha i-insulin sisebenzisa iphampu sivumela inhlanganisela yejubane lokulinganisa inqubo yokuqashelwa kwe-insulin emzimbeni womuntu, onama-pancreas aphilile. Lapho usebenzisa iphampu, i-catheter kufanele ithathelwe indawo zonke izinsuku ezintathu.
Ukusebenzisa iphampu kagesi kukuvumela ukuxazulula izinkinga ngokulingisa inqubo yokutholwa kwemvelo kwe-insulin emzimbeni womuntu.
Ukwenza ukwelashwa kwe-insulin ebuntwaneni
Ukwelashwa kwe-insulin ezinganeni kudinga indlela eyodwa futhi kudinga inani elikhulu lezinto nezimpawu zomzimba womuntu lapho ekhetha inqubo.
Lapho ukhetha uhlobo lwe-insulin yokwelapha isifo sikashukela sohlobo 1 ezinganeni, ukuthandwa kunikezwa ekuphathweni kwezidakamizwa ezi-2- no-3 zemithi equkethe i-insulin emzimbeni wengane.
Isici sokwelashwa kwe-insulin ezinganeni ukuhlanganiswa kwe-insulin nenkathi ehlukile yesenzo ukunciphisa inani lemijovo ngosuku.
Ezinganeni ezineminyaka yobudala engaphezu kweminyaka eyi-12, kunconywa ukusebenzisa indlela yokuqinisa yokwelapha.
Isici somzimba wengane wukuzwela okwengeziwe kwe-insulin uma kuqhathaniswa nomzimba womuntu omdala. Lokhu kudinga ukuthi i-endocrinologist iguqule kancane kancane isilinganiso se-insulin ethathwa ingane. Uma ingane itholakala nohlobo lokuqala lwesifo sikashukela, khona-ke ukulungiswa kufanele kube kuhla lwamayunithi ama-1-2 ngomjovo ngamunye, futhi umkhawulo wokuvumela wokulungiswa wesikhathi esisodwa ovunyelwe akufanele ube ngaphezu kwama-4 amayunithi.
Ukuhlolwa okuyikho kokulungiswa, kuyadingeka ukubheka izinguquko emzimbeni wezinsuku eziningana.
Lapho wenza ushintsho, ama-endocrinologists awancomi ngesikhathi esifanayo ukuguqula imithamo ehambisana nokuphathwa kwe-insulin emzimbeni nasekuseni kusihlwa.
Ukwelashwa kwe-insulin nemiphumela yokwelashwa okunjalo
Lapho uvakashela udokotela-endocrinologist, iziguli eziningi zikhathazeka ngokuthi ukwelashwa nge-insulin kwenziwa kanjani nokuthi yimiphi imiphumela engatholwa kusetshenziswa ukwelashwa ngezidakamizwa eziqukethe i-insulin.
Esimweni ngasinye ngasinye, uhlobo oluqondile lokwelashwa lakhiwa ngu-endocrinologist. Njengamanje, sekwenziwe amapeni akhethekile wesirinji ezigulini ukwenza lula ukwelashwa. Uma kungekho owokugcina, ama-insulin ama-insulin anenalithi elincanyana kakhulu ye-insulin angasetshenziswa.
Ukwelashwa nge-insulin esigulini esinesifo sikashukela kwenziwa ngokuya ngohlelo olulandelayo:
- Ngaphambi kokwenza ukuphathwa kwe-insulin emzimbeni, ukuxova isayithi lomjovo kufanele kwenziwe.
- Ukudla akumele kwenziwe kungakapheli imizuzu engama-30 ngemuva kokuphathwa umuthi.
- Umthamo omkhulu wokuphatha olulodwa akufanele wedlule amayunithi angama-30.
Ukusetshenziswa kwamapeni wesirinji kuyathandwa futhi kuphephile. Ukusetshenziswa kwamapeni ngesikhathi sokwelashwa kubhekwa njengokunengqondo ngezizathu ezilandelayo:
- Ukuba khona kwenaliti ngokucija okukhethekile esibayeni sesirinji kunciphisa izinhlungu ngesikhathi somjovo.
- Ukulungiselela ukwakheka kwe-pen-syringe kukuvumela ukuthi usebenzise idivaysi nganoma yisiphi isikhathi futhi noma kuphi, uma kunesidingo, ukujova i-insulin.
- Amanye amamodeli wamapeni wesirinji anamuhla afakwe izimbotshana ze-insulin. Lokhu kuvumela ukuhlanganiswa kwezidakamizwa kanye nokusetshenziswa kwama-regimens ahlukahlukene ekwelapheni inqubo yokwelashwa.
Indlela yokwelashwa yesifo sikashukela emijovo ye-insulin ifaka lezi zinto ezilandelayo:
- Ngaphambi kokudla kwasekuseni, isiguli sikashukela siyadingeka ukuphatha i-insulin emfushane noma ende.
- Ukuphathwa kwe-insulin ngaphambi kwasemini kufanele kufake umthamo oqukethe ukulungiswa kwesikhashana.
- Umjovo ngaphambi kokudla kwakusihlwa kufanele uqukathe i-insulin esebenza kancane.
- Umthamo wesidakamizwa esikhishwa ngaphambi kokulala kufanele ufake umuthi wesenzo owenziwa isikhathi eside.
Ukufakwa emzimbeni kungenziwa ezindaweni eziningi zomzimba womuntu. Izinga lokumuncwa endaweni ngayinye yalo.
Ukufakwa ngokushesha okukhulu kwenzeka lapho umuthi uphathwa ngaphansi kwesikhumba esiswini.
Izinkinga zokwelashwa kwe-insulin
Ukwenza ukwelashwa okwelashwa, njenganoma yikuphi okunye ukwelashwa, akunakuba ne-contraindication kuphela, kodwa futhi nezinkinga. Enye yezindlela zokubonakaliswa kwezinkinga ezivela ekwelashweni kwe-insulin ukusabela kokungezwani komzimba endaweni yemijovo.
Ukonakala okuvame kakhulu kwama-allerg kungenxa yobuchwepheshe bokujova obungalungile lapho usebenzisa izidakamizwa eziqukethe i-insulin. Imbangela yokungezwani komzimba kungaba ukusetshenziswa kwezinaliti ezifiphele noma eziwugqinsi lapho ufela, ungahloselwe ukuphathwa kwe-insulin, ngaphezu kwalokho, imbangela yokungezwani komzimba kungaba yindawo yomjovo engalungile nezinye izinto.
Enye inkinga yokwelashwa kwe-insulin ukwehla kushukela wegazi lesiguli nokukhula kwe-hypoglycemia emzimbeni. Isimo se-hypoglycemia sisifo emzimbeni womuntu.
Ukuvela kwe-hypoglycemia kungabangelwa ukwephulwa ekukhetheni umthamo we-insulin noma ukuzila okungapheli. Imvamisa i-glycemia yenzeka ngenxa yomthwalo ophakeme ngokwengqondo kumuntu.
Enye inkinga ebhekene nokwelashwa kwe-insulin yi-lipodystrophy, isibonakaliso esiyinhloko okuwukunyamalala kwamafutha angaphansi ezindaweni zomjovo. Ukuze uvikele ukuthuthukiswa kwale nkinga, indawo yomjovo kufanele ishintshwe.
Kwividiyo ekulesi sihloko, indlela yokusebenzisa i-insulin usebenzisa ipeni yesirinji ikhonjiswe kahle.
