I-analogue ye-insulin yomuntu ongena kalula enomphumela owenziwa isikhathi eside (obangelwa ukuzibandakanya okuqinile kokuhlangana kwama-molecule we-insulin endaweni yokuphatha kanye nokusebenzisana kwamangqamuzana ezidakamizwa ane-albhamuin ngokuxhumana ne-acid-fatty acid chain chain nephrofayili yesenzo (okungafani nokuqhathaniswa ne-insulin glargine ne-isofan) .
Uma kuqhathaniswa ne-insulin-isofan, isitholi se-insulin sihlakazeka kancane emathanjeni okuhlosiwe kuwo, okuqinisekisa ukutholwa okukhiqizayo kanye nomphumela odingekile womenzeli. Ukusebenzisana okuhle ne-receptor ye-membtane yeseli ye-cytoplasmic yangaphandle kuyaphawulwa.
Umuthi futhi udala i-insulin-receptor complex esebenza kusebenze izinqubo ezenzeka ngaphakathi kwamaseli, kufaka phakathi futhi ivuselela ukwakheka kwama-enzymes athile (ngokwesibonelo, i-glycogen synthetase).
Ukwehla ushukela wegazi kubangelwa:
- ukwanda kokuhanjiswa kwayo ngaphakathi kwamangqamuzana;
- kusebenze kwe-glycogenogeneis, lipogenesis;
- ukukhuphuka kwe-digestibility yezicubu;
- ukwehla kwezinga lokukhiqizwa koshukela isibindi.
Ngemuva komjovo wesidakamizwa (amayunithi angu-0,2-0.4 / kg ama-50%), inani eliphakeme lokusebenza kahle litholakala ngemuva kwamahora angama-3-4 futhi lihlala amahora angama-14. Isikhathi somphumela sifinyelela osukwini olungu-1.
I-TCmax - kusuka emahoreni ayi-6 kuye kwayi-8. I-Css, inqobo nje uma ihanjiswa kabili ngosuku, ingatholakala ngemuva komjovo wesibili. Ukuhanjiswa kungu-0,1 l / kg.
I-Metabolism iyafana nokutholwa kwe-insulin yomuntu, wonke ama-metabolites akhiwe angamane awele. T1 / 2 kusuka emahoreni amahlanu kuya kwayi-7.
Ukuxhumana nezinye izindlela
Ukuqinisa isenzo se-hypoglycemic kunomthelela ku:
- Izidakamizwa eziqukethe i-ethanol;
- izidakamizwa ze-hypoglycemic (ngomlomo);
- Li +;
- Mao inhibitors;
- fenfluramine,
- Ama-inhibitors e-ACE;
- cyclophosphamide;
- i-carbonic anhydrase inhibitors;
- theophylline;
- ama-beta-blockers angakhethi;
- i-pyridoxine;
- bromocriptine;
- i-mebendazole;
- ama-sulfonamides;
- ketonazole;
- ama-anabolic agents;
- hlanganisa;
- tetracyclines.
Izidakamizwa ezinciphisa i-Hypoglycemic
I-Nicotine, inzalo yokuvimbela inzalo (ngomlomo), i-corticosteroids, i-phenytoin, ama-hormone e-thyroid, i-morphine, i-thiazide diuretics, i-diazoxide, i-heparin, i-calcium blockers (i-slowly), ama-antidepressant ama-triceclic, i-clonidine, i-danazole kanye ne-sympathomimets anciphisa umphumela we-hypoglycemic.
Ama-salicylates ne-reserpine ayakwazi ukuthuthukisa noma ukunciphisa umphumela i-detemir enawo kwi-insulin. I-Lanreotide ne-octreotide iyanda noma inciphise ukufunwa kwe-insulin.
Nakani! Ama-Beta-blockers, ngenxa yezindawo zawo ezihlukile, avame ukuvala uphawu we-hypoglycemia futhi abambezelele ukubuyiselwa kwamazinga e-glucose ajwayelekile.
Izidakamizwa eziqukethe i-Ethanol zikhulisa futhi zikhuphule umphumela we-insogulin. Umuthi awuhambisani nezidakamizwa ezisuselwa ku-sulfite noma thiol (insulin detemir). Futhi, umuthi awukwazi ukuxutshwa nezixazululo zokufakwa.
Imiyalo ekhethekile
Awungeke ufake ukungena kokuzonda ngenkani, ngoba kungavela uhlobo olunamandla lwe-hypoglycemia. Ukwelashwa okujulile nomuthi akufaki sandla ekuqoqweni kwamaphawundi angeziwe.
Uma kuqhathaniswa namanye ama-insulin, i-insulin detemir yehlisa ingozi ye-hypoglycemia ebusuku futhi inesandla ekukhetheni okuphezulu komthamo okuhloswe ngawo ukufeza ukuqina okuqinile koshukela egazini.
Kubalulekile! Ukuyeka ukwelashwa noma umthamo ongalungile wesidakamizwa, ikakhulukazi wohlobo I sikashukela, kunomthelela ekubonakala kwe-hyperglycemia noma i-ketoacidosis.
Izimpawu zokuqala ze-hyperglycemia ikakhulukazi zivela ezigabeni. Avela emahoreni ambalwa noma ezinsukwini. Izimpawu ze-hyperglycemia zifaka:
- iphunga le-acetone ngemuva kokuphefumula;
- ukoma
- ukuntuleka kokudla;
- i-polyuria;
- umuzwa wokuba womile emgodini womlomo;
- isicanucanu
- isikhumba esomile
- ukuqunjelwa;
- hyperemia;
- ukozela okungapheli.
Ukuzivocavoca okungazelelwe futhi okukhulu, nokudla okungajwayelekile nakho kunomthelela ku-hypoglycemia.
Kodwa-ke, ngemuva kokuqala kabusha kwe-carbohydrate metabolism, izimpawu zesimo esibonakalayo se-hypoglycemia zingashintsha, ngakho-ke isiguli kufanele saziswe udokotela ohambelayo. Izimpawu ezejwayelekile zingavimba uma unesifo sikashukela isikhathi eside. Izifo ezithathelwanayo ezihambisana nazo zandisa isidingo se-insulin.
Ukudluliselwa kwesiguli kuhlobo olusha noma i-insulin, eyenziwe ngomunye umenzi, kuhlale kwenziwa ngaphansi kokuqashwa ngudokotela. Uma kwenzeka ushintsho kumenzi, umthamo, uhlobo, uhlobo noma indlela yokwenza i-insulin, ukulungiswa komthamo kuvame ukufuneka.
Iziguli ezidluliselwa ekwelashweni lapho i-insulin isebenzisa khona i-insulin ngokuvamile zidinga ukulungiswa kwamthamo uma kuqhathaniswa nenani le-insulin ekhishwe ngaphambili. Isidingo sokushintsha umthamo sivele ngemuva kokwethulwa komjovo wokuqala noma phakathi nesonto noma inyanga. Inqubo yokumunyisa umuthi esimweni sokuphathwa kwe-intramuscular is ngokushesha impela uma uqhathanisa nokuphathwa kwe-sc.
I-Detemir izoshintsha inani layo lesenzo uma lihlanganiswa nezinye izinhlobo ze-insulin. Ukuhlanganiswa kwayo ne-insulin aspart kuzoholela kuphrofayela yesenzo ngokusebenza okuphansi, okumisiwe okuphezulu uma kuqhathaniswa nokuphatha okunye. I-Detemir insulin akufanele isetshenziswe emapompini e-insulin.
Kuze kube manje, akukho datha ekusetshenzisweni kwemithi komtholampilo ngesikhathi sokukhulelwa, i-lactation nezingane ezingaphansi kweminyaka eyisithupha.
Isiguli kufanele sixwayise ngamathuba we-hyperglycemia ne-hypoglycemia lapho kusenziwa ukushayela imoto nokulawula izindlela. Ikakhulu, kubalulekile kubantu abanezimpawu ezithambile noma ezingekho ezandulele i-hypoglycemia.
Izinkomba zokusetshenziswa nomthamo
Isifo sikashukela yisifo esiyinhloko lapho kukhonjiswa khona umuthi.
Ukufakwa kwenziwa ehlombe, isisu sesisu noma ethangeni. Izindawo lapho injulin insulin ifakwa khona kumele ihlatshwe njalo. Imithamo nemvamisa yemijovo isungulwa ngawodwana.
Lapho ujovwe kabili ukuze wandise ukulawula ushukela, kuyalulekwa ukuphatha umthamo wesibili ngemuva kwamahora ayi-12 emva kokuqala, ngesikhathi sokudla kwakusihlwa noma ngaphambi kokulala.
Ukulungiswa komthamo nesikhathi sesikhathi sokuphatha singadingeka uma isiguli sidluliswa sisuswa ku-insulin isikhathi eside nomuthi osebenza okwejwayelekile usifaka ekuzameni kwe-insulin.
Imiphumela emibi
Imiphumela emibi ejwayelekile (1 kwabangu-100, ngesinye isikhathi i-1 kweziyi-10) ifaka i-hypoglycemia nazo zonke izimpawu zayo zesilungu: isicanucanu, ukuthambeka kwesikhumba, ukwanda kokudla, ukudideka, isimo sezinzwa kanye nokuphazamiseka kwengqondo okungaholela ekufeni. Ukuphendula kwasendaweni (ukulunywa, ukuvuvukala, i-hyperemia endaweni yokujova) nakho kungenzeka, kepha kungokwesikhashana futhi kuyanyamalala ngesikhathi sokwelashwa.
Imiphumela emibi engemihle (1/1000, kwesinye isikhathi i-1/100) ifaka:
- umjovo lipodystrophy;
- ukuvuvukala kwesikhashana okwenzeka ekuqaleni kokwelashwa kwe-insulin;
- ukubonakaliswa komzimba (ukwehla komfutho wegazi, i-urticaria, i-palpitations nobunzima bokuphefumula, ukulunywa, ukungasebenzi kahle kwendlela yokugaya ukudla, i-hyperhidrosis, njll.);
- esigabeni sokuqala sokwelashwa kwe-insulin, ukwephulwa kwesikhashana kokuvela kabusha;
- isifo sikashukela sikashukela.
Ngokuphathelene ne-retinopathy, ukulawulwa isikhathi eside kwe-glycemic kunciphisa amathuba okukhula kwe-pathology, kepha ukwelashwa okuqinile kwe-insulin ngokwanda okungazelelwe kokulawulwa kwe-carbohydrate metabolism kungadala ukuphazamiseka kwesikhashana kwesimo se-retinopathy yesifo sikashukela.
Imiphumela engathandeki kakhulu (1/10000, ngesinye isikhathi 1/1000) imiphumela emibi ifaka phakathi i-peripheral neuropathy noma i-acute pain neuropathy, evame ukuguquguqulwa.
Ukweqisa
Isibonakaliso esiyinhloko sokweqisa kwemithi yi-hypoglycemia. Isiguli singasusa uhlobo olubi lwe-hypoglycemia ngokwalo ngokudla ushukela noma ukudla kwe-carbohydrate.
Esimweni se-s / c esibuhlungu, i / m ilawulwa nge-0.5-1 mg ye-glucagon noma isixazululo se-dextrose ku / in. Uma ngemuva kwemizuzu engu-15 ngemuva kokuthatha i-glucagon, isiguli singabuyanga sazi, khona-ke kufanele kukhishwe isixazululo se-dextrose. Lapho umuntu ebuyela ezingqondweni ngezinhloso zokuvimbela, kufanele adle ukudla okugcwele ama-carbohydrate.
