Okwamanje eRussia kunabantu abangaba yizigidi eziyishumi abatholakala benesifo sikashukela. Lesi sifo, njengoba wazi, sihlotshaniswa nokuphula umthetho wokukhiqizwa kwe-insulin ngamangqamuzana pancreas, anecala le-metabolism emzimbeni.
Ukuze isiguli siphile ngokugcwele, kudingeka afake insulin njalo nsuku zonke.
Namuhla isimo sinje ukuthi emakethe yemikhiqizo yezokwelapha amaphesenti angaphezu kwangama-90 izidakamizwa ezenziwe ngaphandle - lokhu kuyasebenza naku-insulin.
Ngaleso sikhathi, namuhla izwe libhekene nomsebenzi wokwenziwa kwendawo ukukhiqizwa kwemithi ebalulekile. Ngalesi sizathu, namuhla yonke imizamo ihlose ukwenza i-insulin yasekhaya ibe yi-analogue efanelekile yama-hormone aziwa emhlabeni wonke akhiqizwayo.
Ukukhishwa kwe-insulin yaseRussia
I-World Health Organisation income ukuthi amazwe anenqwaba yezakhamizi ezingaphezu kwezigidi ezingama-50 ahlele okwawo ukukhiqizwa kwe-insulin ukuze abantu abanesifo sikashukela bangazitholi izinkinga nge-hormone.
Eminyakeni yamuva nje, umholi ekwakhiweni kwezidakamizwa ezenziwe ngofuzo ezweni kube nguGeropharm.
Nguyena kuphela, eRussia, okhiqiza insulini ezifuywayo ngendlela yezinto nezinto zemithi. Okwamanje, kukhiqizwa insulin esebenza njenge-insulin Rinsulin R kanye ne-insulin esebenza kahle i-Rinsulin NPH lapha.
Kodwa-ke, kungenzeka kakhulu, ukukhiqizwa ngeke kuphele lapho. Mayelana nesimo sezepolitiki ezweni kanye nokufakwa kwezinyathelo zokuthikamezwa kwabakhiqizi bangaphandle, uMongameli waseRussia uVladimir Putin uyalelwe ukuthi azibandakanye ngokugcwele ekuthuthukiseni ukukhiqizwa kwe-insulin nokwenza ucwaningo lwezinhlangano ezikhona.
Kuhlelwa nokuthi kwakhiwe yonke indawo edolobheni lasePushchina, lapho kuzovezwa khona zonke izinhlobo zama-hormone.
Ngabe i-insulin yaseRussia izongena esikhundleni sezidakamizwa zakwamanye amazwe
Ngokusho kokubuyekezwa kwesazi, okwamanje iRussia ayisiyona imbangi yokuncintisana emakethe yomhlaba wonke yokwenziwa kwe-insulin. Abakhiqizi abaphambili yizinkampani ezinkulu ezintathu - u-Eli-Lilly, Sanofi noNovo Nordisk. Kodwa-ke, ngaphezulu kweminyaka eyi-15, i-insulin yasekhaya izokwazi ukufaka esikhundleni samaphesenti angama-30- 40 esamba senani eliphelele lama-hormone athengisiwe ezweni.
Iqiniso ngukuthi uhlangothi lwaseRussia selubeke isikhathi eside umsebenzi wokuhlinzeka izwe nge-insulin yalo, kancane kancane lithathe izidakamizwa ezenziwe kwamanye amazwe.
Ukukhiqizwa kwe-homoni kwaqalwa emuva ezikhathini zaseSoviet, kepha kwase kukhiqizwa i-insulin yemvelaphi yezilwane, eyayingenakho ukuhlanzeka okuphezulu.
Eminyakeni yama-90s, kwenziwa umzamo wokuhlela ukukhiqizwa kwe-insulin yofuzo lofuzo lwasekhaya, kepha izwe lalibhekene nezinkinga zezezimali, futhi umbono wamiswa.
Yonke le minyaka, izinkampani zaseRussia bezama ukukhiqiza izinhlobo ezahlukene ze-insulin, kepha imikhiqizo yangaphandle yayisetshenziswa njengezinto. Namuhla, izinhlangano ezilungele ukukhipha umkhiqizo wasekhaya ogcwele seziqalile ukuvela. Enye yazo yinkampani yakwaGeropharm echazwe ngenhla.
- Kuhlelwa ukuthi ngemuva kokwakhiwa kwesitshalo esifundeni saseMoscow, kukhiqizwe izinhlobo zanamuhla zezidakamizwa zabanesifo sikashukela kuleliya lizwe, ezisezingeni eliphakeme ezingancintisana nobuchwepheshe baseNtshonalanga. Amandla wanamuhla wesitshalo esisha nesevele akhona azovumela ukukhiqiza izinto ezifika ku-650 kg ngonyaka owodwa.
- Uzokwethula umkhiqizo omusha ngo-2017. Kulokhu, izindleko ze-insulin zizobe ziphansi kunabalingani bakhe bangaphandle. Uhlelo olunjalo luzoxazulula izinkinga eziningi emkhakheni we-diabetesology yezwe, kufaka phakathi ezezimali.
- Okokuqala, abakhiqizi bazobamba iqhaza ekukhiqizweni kwamahomoni e-ultrashort nama-long-factor. Ngokuhamba kweminyaka emine, kuzodedelwa umugqa ogcwele wazo zonke izikhundla ezine. I-insulin izokhiqizwa emabhodleleni, kuma-cartridge, ezisele kanye nasekusebenzeni kabusha kwesirinji.
Ukuthi ngabe lokhu kunjalo ngempela kuzokwaziwa yini ngemuva kokuthi inqubo yethulwe futhi kubuyekezwe ukubuyekezwa kokuqala kwemithi emisha.
Kodwa-ke, le yinqubo ende kakhulu, ngakho-ke izakhamizi zaseRussia akumele zinethemba lokuthi kuzongeniswa ngokushesha ukungena kuleli.
Iyiphi imfanelo i-hormone yokukhiqiza yasekhaya enayo?
Umphumela ofanele ofanele futhi ongavikeleki kubantu abanesifo sikashukela uthathwa njenge-insulin eyenzelwe ufuzo, ehambelana nekhwalithi yomzimba ne-hormone yangempela.
Ukuhlola ukusebenza kanye nekhwalithi ye-insulin esebenza ngokungagijimisi i-Rinsulin R kanye ne-insulin Rinsulin NPH esezingeni eliphakathi nendawo, kwenziwa ucwaningo lwesayensi olukhombisa umphumela omuhle wokwehlisa ushukela wegazi ezigulini kanye nokungatholakali kokungezwani ngesikhathi sokwelashwa isikhathi eside nemithi eyenziwe eRussia.
Ngaphezu kwalokho, kungaphawulwa ukuthi kuzoba wusizo ezigulini ukuthi zazi kanjani ukuthola iphampu ye-insulin yamahhala, namuhla lolu lwazi lubaluleke kakhulu.
Lolu cwaningo lwaluhilela abanesifo sikashukela abangama-25 abaneminyaka engama-25-58, abatholakala nesifo sikashukela sohlobo lokuqala. Ezigulini ezingama-21, kwaqalwa ifomu elinamandla lalesi sifo. Ngamunye wabo nsuku zonke wayethola umthamo odingekayo we-insulin waseRussia nowangaphandle.
- Izinga le-glycemia ne-glycated hemoglobin egazini leziguli lapho kusetshenziswa i-analogue yasekhaya kwahlala kufinyelela ezingeni elifanayo nalelo lapho kusetshenziswa i-hormone yokukhiqizwa kwangaphandle.
- Iqoqo lama-antibodies nalo alishintshanga.
- Ikakhulu, i-ketoacidosis, ukusabela komzimba, ukuhlaselwa kwe-hypoglycemia akubonwanga.
- Umthamo wansuku zonke we-hormone ngesikhathi sokubhekwa waphathwa ngevolumu efanayo nangesikhathi esijwayelekile.
Ngaphezu kwalokho, kwenziwa isifundo ukuze kuhlolwe ukusebenza kahle kokunciphisa ushukela wegazi usebenzisa izidakamizwa ze-Rinsulin R nezika-Rinsulin NPH. Kwakungekho mehluko obalulekile lapho usebenzisa i-insulin yokukhiqiza kwasekhaya nakwamanye amazwe.
Ngakho-ke, ososayensi baphetha ngokuthi abanesifo sikashukela bangaguqulwa babe izinhlobo ezintsha ze-insulin ngaphandle kwemiphumela. Kulokhu, umthamo kanye nendlela yokuphathwa kwehomoni iyagcinwa.
Esikhathini esizayo, ukulungiswa komthamo osuselwa ekuzihloleni kwesimo somzimba kungenzeka.
Ukusetshenziswa kweRinsulin NPH
Le hormone inobude besikhathi besenzo. Ingeniswa egazini ngokushesha, futhi ijubane lixhomeke kumthamo, indlela nasendaweni yokulawulwa kwehomoni. Ngemuva kokuthi umuthi ukhishwe, uqala isenzo sawo ngehora nesigamu.
Umphumela omkhulu kakhulu ubonwa phakathi kwamahora amane kuya kwayi-12 ngemuva kokungena emzimbeni. Isikhathi sokuchayeka emzimbeni amahora angama-24. Ukumiswa kumhlophe, uketshezi uqobo alunamabala.
Umuthi unqunyelwe isifo sikashukela sohlobo lokuqala nesesibili, kuyanconywa nabesifazane abagulayo ngesikhathi sokukhulelwa.
Contraindication ifaka:
- Ukungabekezelelwa komuntu ngamunye kwesidakamizwa kunoma iyiphi ingxenye eyingxenye ye-insulin;
- Ukuba khona kwe-hypoglycemia.
Njengoba i-hormone ingenakungena ekuvinjelweni kwe-placental, akukho mingcele ekusebenziseni umuthi ngesikhathi sokukhulelwa.
Ngesikhathi sokuncelisa, kuvunyelwe futhi ukusebenzisa i-hormone, kepha-ke, ngemuva kokubeletha kuyadingeka ukuqapha izinga le-glucose egazini futhi, uma kunesidingo, yehlise umthamo.
I-insulin ilawulwa ngokungaziphathi. Umthamo ubekwa udokotela, kuya ngecala elithile lalesi sifo. Umthamo ojwayelekile wosuku ngu-0.5-1 IU ngekhilogremu ngayinye yesisindo.
Umuthi ungasetjenziswa zombili ngokuzimela nangokuhlangana ne-Rinsulin R.
Ngaphambi kokufaka i-insulin, udinga ukugoqa i-cartridge okungenani amahlandla ayishumi phakathi kwezandla, ukuze isisindo singabi namandla. Uma Foam selwakhekile, akunakwenzeka ukusebenzisa isidakamizwa okwesikhashana, ngoba lokhu kungaholela kumthamo ongalungile. Futhi, awukwazi ukusebenzisa i-hormone uma iqukethe izinhlayiya zakwamanye amazwe nama-flakes anamathele ezindongeni.
Ukulungiselela okuvulekile kuvunyelwe ukuba kugcinwe emazingeni okushisa angama-15-25 degrees izinsuku ezingama-28 kusukela ngosuku lokuvulwa. Kubalulekile ukuthi i-insulin igcinwe kude nemitha yelanga nokushisa okungaphandle.
Nge-overdose, i-hypoglycemia ingaqala ukukhula. Uma ukwehla kwe-glucose egazini kuyinto emnene, into engathandeki ingaqedwa ngokufaka ukudla okumnandi okuqukethe inani elikhulu lama-carbohydrate. Uma icala le-hypoglycemia likhulu, kuphakanyiswa isiguli sika-40% kashukela esigulini.
Ukuze ugweme lesi simo, ngemuva kwalokhu udinga ukudla ukudla okune-carb ephezulu.
Isebenzisa iRinsulin P
Lesi sidakamizwa i-insulin esebenza kancane. Ngokubukeka, kuyafana neRinsulin NPH. Ingalawulwa ngokungahambisani, kanye nange-intramuscularly and intravenly ngaphansi kokuqashwa ngokuqinile kodokotela. Umthamo nawo udinga ukuvumelana nodokotela.
Ngemuva kokuthi i-hormone ingene emzimbeni, isenzo sayo siqala engxenyeni yehora. Ukusebenza ngobukhulu kubonwa ngesikhathi samahora ama-1-3. Isikhathi sokuchayeka emzimbeni amahora angama-8.
I-insulin ihanjiswa ngesigamu sehora ngaphambi kokudla noma ukudla okulula okukhishwa ngenani elithile lama-carbohydrate. Uma kusetshenziswa umuthi owodwa kuphela wesifo sikashukela, i-Rinsulin P ihanjiswa kathathu ngosuku, uma kunesidingo, umthamo ungakhuphuka ufike kathathu ngosuku.
Umuthi unqunyelwe isifo sikashukela sohlobo lokuqala nesesibili, ngesikhathi sokukhulelwa, kanye nokubuyiswa kwe-carbohydrate metabolism njengesinyathelo esiphuthumayo. Contraindication ifaka ukungabekezelelani komuntu ngamunye kulo muthi, kanye nokuba khona kwe-hypoglycemia.
Lapho usebenzisa i-insulin, ukusabela komzimba, ukumiswa kwesikhumba, ukuvuvukala, kanye nokuxakaniseka okungajwayelekile kungenzeka.
