I-insulin esheshayo yomuntu iqala ukusebenza kungakapheli imizuzu engama-30-45 ngemuva komjovo, izinhlobo zanamuhla ezifushane ze-insulin (i-Apidra, NovoRapid, Humalog) - ngisho ngokushesha, zidinga imizuzu eyi-10-15 kuphela. I-Apidra, i-NovoRapid, i-Humalog - lokhu akuyona i-insulin ngempela yabantu, kodwa ama-analogues ayo amahle kuphela.
Ngaphezu kwalokho, uma kuqhathaniswa ne-insulin yemvelo, le mishanguzo ingcono ngoba iguqulwa. Ngenxa yendlela yabo ethuthukisiwe, le mishanguzo, ngemuva kokungena emzimbeni, inciphisa ngokushesha kakhulu ukugcwala koshukela egazini.
Ama-analog e-insulin amafushane aqhamuke ngqo asetshenziselwe ukucindezela ngokushesha ama-glucose egazini. Lesi simo sivame ukwenzeka lapho onesifo sikashukela efuna ukudla ngokushesha ama-carbohydrate.
Ekusebenzeni, ngeshwa, lo mbono awuzange uzithethelele, ngoba ukusetshenziswa kwemikhiqizo evinjelwe ushukela, noma kunjalo, kuphakamisa ushukela wegazi.
Noma izidakamizwa ezinjenge-Apidra, NovoRapid, iHumalog zitholakala kumculi wesiguli, umuntu onesifo sikashukela kufanele abambelele ekudleni okune-carb ephansi. Ama-analog we-Ultrafast we-insulin asetshenziswa ezimweni lapho kudingeka ukunciphisa amazinga kashukela ngokushesha okukhulu.
Esinye isizathu esenza kwesinye isikhathi kufanele uguqukele kwi-insulin ye-ultrashort kulapho kungenakwenzeka khona ukulinda imizuzu eyi-40-45 ebekiwe ngaphambi kokudla, okudingekayo ukuqala isenzo se-insulin ejwayelekile.
Imijovo ye-insulin esheshayo noma ye-ultrafast ngaphambi kokudla iyadingeka kulabo abanesifo sikashukela abahlakulela i-hyperglycemia ngemuva kokudla.
Hhayi njalo ngesifo sikashukela, ukudla okune-carbohydrate ephansi kanye nezidakamizwa ezidliwayo zinomphumela ofanele. Kwezinye izimo, lezi zinyathelo zinikeza isiguli kuphela impumuzo ethile.
Thayipha isifo sikashukela esinengqondo sinengqondo ukuzama i-insulin ende kuphela ngesikhathi sokwelashwa. Kungenzeka ukuthi ukuba nesikhathi sokuthatha ikhefu kusuka kumalungiselelo e-insulin, ipancreas iyathelwa phezulu futhi izoqala ngokuzimela ukukhiqiza i-insulin futhi ikhiphe ukuqhuma kwe-glucose egazini ngaphandle kwemijovo eyandulelayo.
Kunoma yikuphi ukunakekelwa komtholampilo, isinqumo ngohlobo lwe-insulin, imithamo yaso kanye namahora okwamukelwa kwenziwa kuphela ngemuva kokuba isiguli sizihlole ngokuphelele i-glucose yegazi okungenani izinsuku eziyisikhombisa.
Ukuhlanganisa uhlelo lolu, udokotela kanye nesiguli kuzodingeka basebenze kanzima.
Ngemuva kwakho konke, ukwelashwa kwe-insulin ekahle akufanele kufane nokwelashwa okujwayelekile (imijovo eyi-1-2 ngosuku).
Ukwelashwa kwe-insulin okusheshayo futhi okuyi-ultrafast
I-Ultrashort insulin iqala isenzo sayo ngaphambili kakhulu kunokuba umzimba womuntu ukwazi ukuphula futhi udonse amaprotheni, amanye awo aguqulwa abe ushukela. Ngakho-ke, uma isiguli sinamathela ekudleni okune-carb ephansi, i-insulin esebenza ngokushesha, enikezwe ngaphambi kokudla, ingcono kune:
- I-Apidra
- I-NovoRapid,
- Isi-Humalogue.
I-insulin esheshayo kufanele iphathwe imizuzu engama-40-45 ngaphambi kokudla. Lesi sikhathi siyabonakala, futhi esigulini ngasinye simiswa ngokuqondile. Isikhathi sokusebenza kwama-insulin amafushane cishe amahora amahlanu. Kungalesi sikhathi lapho umzimba womuntu ufuna ukugaya ngokuphelele ukudla okudliwayo.
I-Ultrashort insulin isetshenziswa ezimweni ezingalindelekile lapho izinga ushukela kufanele lehliswe ngokushesha okukhulu. Izinkinga zesifo sikashukela ziba ngokuqondile esikhathini lapho ukugcwala kweglucose egazini kukhuphuka, ngakho-ke kuyadingeka ukwehlisela kokujwayelekile ngokushesha. Futhi kulokhu, i-hormone yesenzo se-ultrashort ilingana ngokuphelele.
Uma isiguli sinezinkinga zikashukela "ezinobumnene" (ushukela ujwayelekile ngokwaso futhi kwenzeka ngokushesha), imijovo eyengeziwe ye-insulin ekulesi simo ayidingeki. Lokhu kungenzeka kuphela ngesifo sikashukela sohlobo 2.
I-insulin ye-Ultrafast
Ama-insrain we-Ultra asheshayo afaka i-Apidra (Glulisin), NovoRapid (Aspart), Humalog (Lizpro). Le mishanguzo ikhiqizwa izinkampani ezintathu zemithi eziqhudelanayo. I-insulin ejwayelekile yomuntu imfushane, futhi i-ultrashort - lezi yizichazi, okungukuthi, ezithuthukiswa uma ziqhathaniswa ne-insulin yangempela yabantu.
Umnyombo wentuthuko ukuthi izidakamizwa ze-ultrafast zehlisa amazinga kashukela ngokushesha okukhulu kunalezi ezimfushane. Umphumela wenzeka emizuzwini emi-5-16 ngemuva komjovo. Ama-insulin ama-Ultrashort adalwe ngokuqondile ukunika amandla abanesifo sikashukela ngezikhathi ezithile ukuba badle kuma-carbohydrate wokugaya ukudla.
Kepha leli cebo alisebenzi. Kunoma ikuphi, ama-carbohydrate akhuphula ushukela ngokushesha kunokuba i-insulin yesimanje kakhulu ebamba ngokweqile ingalinciphisa. Ngaphandle kokuvela kwezinhlobo ezintsha ze-insulin emakethe yezokwelapha, isidingo sokudla okuphansi kwe-carbohydrate sikashukela sihlala sisebenza. Le ndlela ukuphela kwendlela yokugwema izinkinga ezinkulu ezifakwa yisifo esingaqondakali.
Kwabanesifo sikashukela sohlobo loku-1 no-2, kulandela ukudla okune-carbohydrate ephansi, i-insulin yabantu ibhekwa njengekulungele kakhulu ukujova ngaphambi kokudla, kunokuba i-ultrashort analogues. Lokhu kungenxa yokuthi umzimba wesiguli onesifo sikashukela, odla ama-carbohydrate ambalwa, okokuqala ugaya amaprotheni, bese ingxenye yawo iguqulwa ibe ushukela.
Le nqubo yenzeka kancane kakhulu, futhi isenzo se-insulin ye-ultrashort, kunalokho, senzeka ngokushesha okukhulu. Kulokhu, vele usebenzise i-insulin. I-insulin yokubopha kufanele ibe imizuzu engama-40-45 ngaphambi kokudla.
Ngaphandle kwalokhu, ama-insulin asebenza kakhulu osheshayo angahle abe wusizo kwabanesifo sikashukela abavimbela ukungena kwe-carbohydrate. Uma isiguli siphawula izinga likashukela eliphakeme kakhulu lapho sithatha i-glucometer, kulesi simo ama-insulin angaphezulu kakhulu asiza kakhulu.
I-Ultrashort insulin ingasiza ngaphambi kokudla esitolo sokudlela noma ngesikhathi sohambo lapho kungekho ndlela yokulinda imizuzu eyabelwe engama-40-45.
Kubalulekile! Ama-insrain amafushane kakhulu asebenza ngokushesha kakhulu kunawo amafushane. Kulokhu, imithamo ye-ultrashort analogues ye-hormone kufanele ibe phansi kakhulu kunemithamo efanayo ye-insulin emfushane yomuntu.
Ngaphezu kwalokho, izivivinyo zomtholampilo zezidakamizwa zikhombisile ukuthi umphumela weHumalog uqala imizuzu emi-5 ngaphambi kwalapho usebenzisa i-Apidra noma iNovo Rapid.
Izinzuzo kanye nokubi kwe-insulin ye-ultrafast
Ama-analog entsha asheshayo we-insulin (uma eqhathaniswa nama-hormone omuntu amafushane) anezinzuzo nokubi okuthile.
Izinzuzo:
- Inani eliphakeme lesenzo. Izinhlobo ezintsha ze-insulin ze-ultrashort ziqala ukusebenza ngokushesha okukhulu - ngemuva komjovo ngemuva kwemizuzu engu-10-15.
- Isenzo esihle sokulungiselela okufushane sinikezela ukwamukelwa okungcono kokudla komzimba, inqobo nje uma isiguli silandela ukudla okune-carbohydrate ephansi.
- Ukusetshenziswa kwe-insulin ye-ultrafast kulula kakhulu lapho isiguli singasazi isikhathi sokudla okulandelayo, ngokwesibonelo, uma isendleleni.
Ngokuya ekudleni okuphansi kwe-carbohydrate, odokotela batusa ukuthi iziguli zabo, njengenjwayelo, zisebenzisa i-insulin efushane yomuntu ngaphambi kokudla, kepha zigcine izidakamizwa ziluhlaza zikulungele izikhathi ezikhethekile.
Okubi:
- Izinga likashukela wegazi lehlile kunasemuva komjovo we-insulin ejwayelekile.
- Ama-insulin amafushane kufanele aphathwe imizuzu engama-40-45 ngaphambi kokuthi uqale ukudla. Uma ungasibheki lesi sikhathi futhi uqale isidlo ngaphambili, ukulungiselela okufushane ngeke kube nesikhathi sokuqalisa isenzo, noshukela wegazi uzogxuma.
- Ngenxa yokuthi amalungiselelo we-insulin e-ultrafast enenhliziyo ebukhali, kunzima kakhulu ukubala ngokunembile inani lama-carbohydrate okumele adliwe ngesikhathi sokudla, ukuze ukuhlangana kweglucose egazini kuvamile.
- Ukuzijwayeza kuyaqinisekisa ukuthi izinhlobo ze-insulin zisebenza ngokuzinza kakhudlwana kushukela egazini kunezifushane. Umphumela wazo awubonakali ngisho noma ujovwe kumithamo emincane. Asikho isidingo sokukhuluma ngemithamo emikhulu kulokhu.
Iziguli kufanele zikhumbule ukuthi izinhlobo ze-insulin zokugcina zinamandla kakhulu kunashesha. Iyunithi eli-1 leHumaloga lizonciphisa ushukela wegazi izikhathi ezi-2,5 ezinamandla kuneyunithi eli-1 le-insulin efushane. I-Apidra neNovoRapid cishe zinamandla izikhathi eziphindwe ka-1.5 kune-insulin emfushane.
Ngokuhambisana nalokhu, umthamo weHumalog kufanele ulingane nemithamo ye-insulin engu-0,4 ngokushesha, kanye nomthamo we-Apidra noma uNovoRapida - isilinganiso se-⅔. Lomthamo uthathwa njengophawuleka, kepha umthamo ngqo unqunywa esimweni ngasinye ngokomqondo.
Umgomo oyinhloko okufanele wonke umuntu onesifo sikashukela alwele ukuwusebenzisa ukunciphisa noma ukuvimbela ngokuphelele i-postprandial hyperglycemia. Ukufeza inhloso, umjovo ngaphambi kokudla kufanele wenziwe ngesilinganiso esanele sesikhathi, okungukuthi, linda isenzo se-insulin bese uqala ke ukudla.
Ngakolunye uhlangothi, isiguli sifuna ukuqinisekisa ukuthi umuthi uqala ukwehlisa ushukela wegazi ngokufanele ngesikhathi lapho ukudla kuqala ukukwandisa. Kodwa-ke, uma umjovo wenziwe kahle kusenesikhathi, ushukela wegazi ungancipha ngokushesha kunokudla ozowukhulisa.
Ekusebenzeni, kuye kwaqinisekiswa ukuthi ukujova i-insulin emfushane kufanele kwenziwe imizuzu engama-40-45 ngaphambi kokudla. Lo mthetho awusebenzi kulabo abanesifo sikashukela abanomlando we-gastroparesis yesifo sikashukela (ukuphuma kancane kwesisu ngemuva kokudla).
Ngesinye isikhathi, kepha noma kunjalo, iziguli ziba lapho ama-insulin amafushane angeniswa egazini ikakhulukazi kancane ngesizathu esithile. Lezi ziguli kufanele zenze imijovo ye-insulin cishe amahora angama-1.5 ngaphambi kokudla. Ngokwemvelo, lokhu kuyaphazamisa kakhulu. Kungenxa yabantu abanjalo ukuthi ukusetshenziswa kwe-ultrashort insulin analogues kufanelekile kakhulu. Eshesha kakhulu kubo nguHumalog.
