Ngaphambi kokuba wonke umuntu onesifo sikashukela, kungekudala, kungavela umbuzo wokukhetha indlela efanelekile yokusebenzisa insulin. I-pharmacology yesimanje inikela ngemijovo kanye nohlobo lwethebhulethi lwaleli hormone.
Kwezinye izimo, hhayi kuphela ikhwalithi yokwelapha, kepha futhi nesikhathi sokuphila sesifo sikashukela sincike ekukhetheni okulungile.
Njengoba umkhuba wezokwelapha ukhombisa, ukudlulisela isifo sikashukela emijozini kuwumsebenzi onzima kunalokho. Lokhu kungachazwa ngokuba khona kwenani elikhulu lezinganekwane nemibono eyiphutha ekhona ngalesi sifo.
Kuyaphawuleka ukuthi le nto ayizange ibonwe nje kuphela phakathi kweziguli, kodwa naphakathi kodokotela. Akuwona wonke umuntu owaziyo ukuthi iyiphi i-insulin engcono kakhulu.
Kungani sidinga imijovo?
Isifo sikashukela sohlobo 2 saziwa ngokuncipha kwamanyikwe nokuncipha komsebenzi kwamaseli we-beta, abhekele ukwenziwa kwe-insulin.
Le nqubo ayikwazi kodwa ukuthinta amazinga kashukela egazini. Lokhu kungaqondakala ngenxa ye-hemoglobin ye-glycated, ekhombisa isilinganiso soshukela ezinyangeni ezi-3 ezedlule.
Cishe bonke abanesifo sikashukela kufanele banake inkomba yabo ngokucophelela futhi njalo. Uma idlula kakhulu imingcele yokujwayelekile (ngokumelene nesizinda sokwelashwa isikhathi eside ngenani elilinganiselanayo lamathebulethi), lokhu-ke kuyisidingo esicacile soguquko ekuphathweni kwe-insulin.
Cishe amaphesenti angama-40 ohlobo lwesifo sikashukela sohlobo 2 adinga ukujova nge-insulin.
Abalingani bethu abahlaselwe yisifo sikashukela, bangena imijovo iminyaka eyi-12-15 ngemuva kokuqala kwalesi sifo. Lokhu kwenzeka ngokukhuphuka okukhulu kwezinga likashukela kanye nokwehla kwe-hemoglobin ye-glycated. Ngaphezu kwalokho, inqwaba yalezi ziguli inezinkinga ezinkulu zalesi sifo.
Odokotela bachaza le nqubo ngokungenakwenzeka kokuhlangabezana namazinga wamazwe ahlonishwayo, naphezu kokuba khona kwabo bonke ubuchwepheshe besimanje bezokwelapha. Isizathu sokuqala salokhu ukwesaba kwesifo sikashukela sokujova impilo yonke.
Uma isiguli esinesifo sikashukela singazi ukuthi iyiphi i-insulin engcono, senqaba ukushintshela kumijovo noma siyeka ukuzenza, khona-ke lokhu kugcwele ushukela wegazi ophakeme ngokweqile. Isimo esinjalo singadala ukukhula kwezinkinga zibe yingozi empilweni nasempilweni yesifo sikashukela.
Ama-hormone akhethwe kahle asiza ekuqinisekiseni isiguli impilo ephelele. Ngenxa yamadivayisi wesimanje aphezulu osetshenziswayo kabusha, kwenzeka ukuthi kuncishiswe ukungaphatheki kahle nobuhlungu bemijovo.
Amaphutha Wempilo Yesifo Sikashukela
Akuvamile ukuthi kunikezwe i-insulin ukwelashwa lapho uqeda ukulethwa kwe-insulin yakho. Esinye isizathu kungaba yizimo ezinjengalezi:
- inyumoniya
- umkhuhlane oyinkimbinkimbi;
- ezinye izifo ezinkulu zangasese;
- ukungakwazi ukusebenzisa umuthi ezibhebheni (ngokuphendula komzimba, izinkinga ngesibindi nezinso).
Ukushintshela kumijovo kungenziwa uma onesifo sikashukela efuna ukuhola indlela yempilo ekhululekile noma, lapho kungekho khona amandla okulandela indlela yokudla enempilo futhi ephelele ye-carb.
Imijovo ayikwazi ngandlela thile ukulimaza kabi isimo sezempilo. Noma yiziphi izinkinga ezingaba khona ngesikhathi sokushintshwa komjovo zingabhekwa njengengozi kanye nengozi. Noma kunjalo, ungaphuthelwa yisikhathi sokuthi kune-overdose ye-insulin.
Isizathu salesi simo akusona i-insulin, kodwa ukuba khona isikhathi eside ngamazinga kashukela egazini angasebenzi. Ngokuphambene nalokho, ngokwezibalo zamazwe omhlaba jikelele, lapho ushintshana nemijovo, isikhathi sokuphila esiphakathi kanye nokunyuka kwekhwalithi yaso.
Ngokuncipha kwe-hemoglobin ye-glycated ngephesenti eli-1, amathuba wezi zinkinga ezilandelayo anciphisa:
- i-myocardial infarction (ngamaphesenti ayi-14);
- ukunqunywa noma ukufa (amaphesenti angama-43);
- izinkinga ze-microvascular (amaphesenti angama-37).
Yinde noma imfishane?
Ukuze ulingise ukufihlwa kwe-basal, kungokwesiko ukusebenzisa ama-insulin okuchayeka isikhathi eside emzimbeni. Kuze kube manje, i-pharmacology inganikeza izinhlobo ezimbili zemithi enjalo. Lokhu kungaba yi-insulin yesikhathi esiphakathi (esisebenza amahora afinyelela ku-16 ngokubandlululwa) kanye nokuvezwa kwe-Ultra-ende (isikhathi sayo singaphezu kwamahora ayi-16).
Ama-hormone eqembu lokuqala afaka:
- IGensulin N;
- I-Humulin NPH;
- I-Insuman Bazal;
- I-Protafan HM;
- I-Biosulin N.
Ukulungiselela kweqembu lesibili:
- ITresiba;
- I-Levemir;
- I-Lantus.
U-Levemir noLantus bahluke kakhulu kuzo zonke ezinye izidakamizwa ngoba banesikhathi esihlukile kakhulu sokuchayeka emzimbeni wesifo sikashukela futhi basobala ngokuphelele. I-insulin yeqembu lokuqala imhlophe enodaka impela. Ngaphambi kokusetshenziswa, i-ampoule enayo kufanele igoqwe ngokucophelela phakathi kwezandla ukuthola isisombululo esinamafu esifanayo. Lo mehluko ungumphumela wezindlela ezahlukahlukene zokukhiqiza imithi.
Ama-insulin aqhamuka eqenjini lokuqala (ubude besikhathi esiphakathi) ayisiqongo. Ngamanye amagama, inani eliphakeme lokuhlushwa lingalandelwa esenzweni sabo.
Izidakamizwa ezivela eqenjini lesibili azibonakalanga ngalokhu. Yilezi zici okufanele zibhekwe lapho ukhetha umthamo ofanele we-insal insulin. Kodwa-ke, imithetho ejwayelekile yawo wonke ama-hormone ayalingana.
Umthamo we-insulin yokuvezwa isikhathi eside kufanele ukhethwe ukuze kugcinwe izinga likashukela wegazi phakathi kokudla phakathi kobubanzi obamukelekayo. Umuthi ubandakanya ukuguquguquka okuncane ebangeni ukusuka ku-1 kuye ku-1.5 mmol / L.
Uma umthamo we-insulin ukhethwe ngokwanele, khona-ke ushukela wegazi akufanele uwe noma ukwanda. Lesi sikhombisi kumele sibanjwe amahora angama-24.
I-insulin ehlala isikhathi eside kufanele ifakwe ngaphandle kwethanyana ethangeni noma ebhulukhweni. Ngenxa yesidingo sokumuncwa ngokushelela nangokuhamba kancane, imijovo engalweni nasesiswini inqatshelwe!
Ukufakwa kulezi zindawo kuzonikeza umphumela ophambene. I-insulin esebenza ngokushesha, esetshenziselwa esiswini noma engalweni, inikeza inani eliphakeme kahle ngesikhathi sokufakwa kokudla.
Ukugwaza kanjani ebusuku?
Odokotela batusa ukuthi abantu abanesifo sikashukela baqale ukujova isikhathi eside ngemijovo ye-insulin. Futhi, qiniseka ukuthi wazi kuphi ukujova i-insulin. Uma isiguli singakakwazi ukwenza lokhu, kufanele sithathe izindlela ezikhethekile njalo ngamahora ama-3:
- ngo-21.00;
- ngo-00,00;
- ngo-03,00;
- ngo-06,00.
Uma nganoma yisiphi isikhathi isiguli esinesifo sikashukela sinokugxila kwezinkomba zikashukela (sinciphile noma sanda), khona-ke kuleli cala, umthamo osetshenzisiwe kufanele ulungiswe.
Esimweni esinjalo, kufanele kubhekwe ukuthi ukwanda kwamazinga kashukela akuyona njalo imiphumela yokuntuleka kwe-insulin. Kwesinye isikhathi lokhu kungaba wubufakazi be-hypently hypemlycemia, okuzwakale ngokukhula kwamazinga kashukela.
Ukuze uqonde isizathu sokukhuphuka ushukela ebusuku, kufanele ucabangele isikhathi sokuphumula njalo ngehora. Kulokhu, kunesidingo sokubheka ukugxila kwe-glucose kusuka ngo-00,00 kuye ku-03.00.
Uma kuzoba nokwehla kwalo kule nkathi, khona-ke kungenzeka ukuthi kube khona okubizwa nge- "pro-bending" okufihliwe nge-rollback. Uma kunjalo, khona-ke umthamo we-insulin ebusuku kufanele wehliswe.
Udokotela ngamunye we-endocrinologist uzosho ukuthi ukudla kuthinta kakhulu ukuhlolwa kwe-insulin eyisisekelo emzimbeni wesifo sikashukela. Isilinganiso esinembe kunazo zonke senani le-insal insulin kungenzeka kuphela uma kungekho glucose egazini oza nokudla, kanye ne-insulin isikhathi esifushane sokuvezwa.
Ngalesi sizathu esilula, ngaphambi kokuhlola i-insulin yakho yasebusuku, kubalulekile ukweqa ukudla kwakho kwakusihlwa noma udle isidlo sakusihlwa kusenesikhathi kunokujwayelekile.
Kungcono ukungasebenzisi i-insulin emfushane ukuze ugweme isithombe esinyantisayo sesimo somzimba.
Ukuze uzihlole, kubalulekile ukulahla ukusetshenziswa kwamaprotheni namafutha ngesikhathi sokudla kwakusihlwa nangaphambi kokuhlola ushukela wegazi. Kungcono ukunikeza ukukhetha kwimikhiqizo ye-carbohydrate.
Lokhu kungenxa yokuthi amaprotheni namafutha adonswa ngumzimba kancane futhi angangezelela kakhulu amazinga kashukela ebusuku. Isimo, futhi, sizoba isithiyo ekutholeni umphumela owanele we-insal insulin ebusuku.
I-insulin yasemini
Ukuhlola i-insal insulin ngesikhathi sasemini, okunye kokudla kufanele kungafakwa ngaphandle. Ngokufanelekile, ungalamba ngisho nosuku usuku lonke, ngenkathi ulinganisa ukugxila kwe-glucose ngehora. Lokhu kuzonikeza ithuba lokusibona kahle isikhathi sokwehla noma ukwanda koshukela wegazi.
Ezinganeni ezincane, le ndlela yokuxilonga ayifanele.
Endabeni yezingane, i-insulin insulin kufanele ibuyekezwe ngezikhathi ezithile. Isibonelo, ungakwazi ukweqa ibhulakufesi bese ulinganisa ukubalwa kwegazi njalo ngehora:
- kusukela umntwana evuka;
- kusukela ngomjovo we-insulin eyisisekelo.
Baqhubeka nokuthatha izilinganiso ngaphambi kwasemini, bese kuthi emva kwezinsuku ezimbalwa weqe ukudla kwasemini, bese kuba isidlo sakusihlwa.
Cishe yonke i-insulin esebenza isikhathi eside kufanele ifakwe kathathu ngosuku. Okuhlukile isidakamizwa iLantus, esifakwa kanye kuphela ngosuku.
Kubalulekile ukukhumbula ukuthi yonke insulin engenhla, ngaphandle kukaLantus noLevemir, kunohlobo lokugcina kokuphakeme. Njengomthetho, inani eliphakeme lale mishanguzo lenzeka kungakapheli amahora angama-6-8 kusukela esikhathini sokuchayeka.
Ngezikhathi eziphakeme, ukwehla kwamazinga kashukela egazini kungenzeka. Lokhu kufanele kulungiswe ngethamo elincane lamayunithi esinkwa.
Odokotela batusa ukuphindaphinda amasheke we-basal insulin ekushintsheni komthamo ngamunye. Kwanele izinsuku ezi-3 ukuqonda amandla ngokuqonda ngasikhathi sinye. Ngokuya ngemiphumela, udokotela uzonquma izindlela ezifanele.
Ukuhlola i-insulin yansuku zonke nokuqonda ukuthi iliphi i-insulin elingcono, linda okungenani amahora angama-4 kusuka ekudleni kwakho kwangaphambilini. Isikhathi sokuphumula esifanele singabizwa ngokuthi amahora angama-5.
Lezo ziguli ezinesifo sikashukela ezisebenzisa i-insulin emfushane kufanele zimelane nesikhathi esingaphezu kwamahora angama-6-8:
- IGensulin;
- I-Humulin;
- I-Actrapid.
Lokhu kuyadingeka ngenxa yezici ezithile zethonya lalawa ma-insulin emzimbeni womuntu ogulayo. Ama-instrin ama-Ultrashort (Novorapid, Apidra noHumalog) awawulaleli lo mthetho.
