I-Basal iqukethe i-insulin efana ne-insulin yabantu ngesakhiwo futhi itholwe kusetshenziswa uhlobo lofuzo lobunjiniyela u-Escherichia Coli K12 135 pINT90d.
Indlela yokusebenza ye-insulin:
- kunciphisa ushukela wegazi, kubambezela imiphumela ye-catabolic, kugqugquzela ukusabela kwe-anabolic;
- kwandisa ukwakheka kwe-glycogen esibindini, emisipha nasekuhambeni kwe-glucose kumaseli;
- kuvimbela i-glyconeogeneis ne-glycogenolysis;
- kuthuthukisa ukusetshenziswa kwe-pyruvate;
- kuvimbela i-lipolysis;
- kwandisa i-lipoenaisis kwezicubu ze-adipose nesibindi;
- ikhuthaza ukwakheka kwamaprotheni kanye nokuthathwa kwe-amino acid kumaseli;
- kwandisa ukugeleza kwe-potassium kumaseli.
I-Insuman Bazal GT isho insulin esebenza isikhathi eside ngokubambezeleka. Ngemuva kokufakwa komuthi, umphumela wokwehla kwamazinga kashukela kwenzeka ngaphakathi kwehora elilodwa, futhi inani lesenzo se-Insuman Bazal GT livela ngemuva kwamahora angama-3-4. Isikhathi somphumela sisukela emahoreni ayi-11 kuye kwangama-20.
I-Pharmacokinetics
Kubantu abaphilile ngokuphelele, T ½ i-plasma insulin cishe imizuzu engama-4-6. Ezigulini ezinokungasebenzi kahle kwezinso, isikhathi eside kakhulu.
Yize kufanele kuphawulwe ukuthi i-pharmacokinetics ye-insulin ayivelisi umphumela wayo we-metabolic. I-insulin inconyelwa ukwelashwa kwe-insulin edinga isifo sikashukela.
Contraindication kuya kwezidakamizwa iBazal
- Ukusabela kwe-Hypersensitivity ku-insulin noma enye ingxenye esekelayo ye-Insuman Bazal GT. Okuhlukile yilezo zimo lapho kungenakwenzeka ukwenza ngaphandle kokusebenzisa i-insulin.
- I-Hypoglycemia
Ngokuqapha ngokweqile, kufanele uphuze umuthi:
- iziguli esezikhulile, ngoba ukwehla okuhlobene nobudala emsebenzini wezinso kuholela ekwehleni kwesidingo se-insulin, futhi lesi sici siyaqhubeka;
- ukwehluleka kwezinso (ngenxa yokwehla kwe-insulin metabolism ezigulini, isidingo se-insulin siyancipha);
- ukwehluleka kwesibindi (ngenxa yokwehla kwe-insulin metabolism kanye nokwehla kwekhono lomzimba we-gluconeogeneis, isidingo se-insulin singancipha);
- i-stenosis enzima yomgogodla we-cerebral and coronary artery (ezigulini ezinalesi sifo, iziqephu ze-hypoglycemic zithola ukubaluleka okukhethekile komtholampilo, lokhu kungenxa yokuthi kunengozi ekhulayo yokuxineka kwenhliziyo noma inhliziyo) ye-hypoglycemia);
- iziguli ezine-retinopathy ekhulayo, ikakhulukazi labo abangazange bathole ukwelashwa nge-laser therapy (Photocoagulation). Lezi ziguli ezine-hypoglycemia zisengozini yokuba ne -ururent amaurosis (ukungaboni ngokuphelele);
- iziguli ezine-pathologies ezihambisanayo, kulezi zimo, iziguli zivame ukukhulisa ukufunwa kwe-insulin.
Kunoma yisiphi isifo salaba abalwe ngenhla, ngaphambi kokuthi uqale usebenzise umuthi, kufanele ufune izeluleko zikadokotela.
Isisekelo ngesikhathi sokukhulelwa nokuqunjelwa
Noma ngabe ukhulelwe, awukwazi ukuphazamisa ukwelashwa nge-Insuman® I-Bazal GT. Lokhu kuphephile ngokuphelele, ngoba i-insulin ayikwazi ukungena ekuvinjelweni kwe-placental.
Futhi kowesifazane owayenesifo sikashukela ngaphambi kokukhulelwa noma athole i-mellitus yesifo sikashukela sokubeletha, ikhwalithi yokulawula ukulawula i-metabolism ngesikhathi sokukhulelwa ibaluleke kakhulu.
Ngesikhathi se-trimester yokuqala yokukhulelwa, isidingo se-insulin singehla, futhi phakathi kwama-trimesters wesibili nowesithathu wokukhulelwa, kuvame ukukhuphuka. Isidingo se-insulin siyancipha futhi ngokushesha ngemuva kokubeletha, owesifazane uba nengozi eyengeziwe yokuba ne-hypoglycemia.
Kukho konke ukukhulelwa nangemva kokuzalwa kwengane, amazinga kashukela wegazi kumele aqashelwe ngokucophelela. Lapho uhlela ukukhulelwa nokuqala kwayo, owesifazane kufanele azise udokotela ozobakhona ngalokhu.
Ngesikhathi sokuncelisa, ayikho imikhawulo ekwelashweni kwe-insulin, yize kungadingeka ukulungiswa kwamthamo.
Imiphumela emibi yesidakamizwa
I-Hypoglycemia
Imiphumela emibi ejwayelekile yokwelashwa kwe-insulin yi-hypoglycemia. Ingakhula uma umthamo we-insulin udlula kakhulu isidingo sawo. Iziqephu eziphindaphindayo ze-hypoglycemia ziholela ekuthuthukisweni kwezimpawu ze-neurological: coma, confulsions.
Iziqephu ezishubile nezinde ze-hypoglycemia zingaba yingozi enkulu ezimpilweni zeziguli. Ngaphambi kokuba isiguli sibe nezimpawu ze-neuroglycemia, sivele sivelise ukusebenza kwe-Reflex kohlelo lwezinzwa olunozwela. Lokhu kuyimpendulo yokuthuthukisa i-hypoglycemia.
Imvamisa, ngokuncipha okusheshayo futhi okukhulunywayo ekugxiliseni ushukela wegazi, izimpawu zokusebenzisa amandla kwe-Reflex kohlelo lwezinzwa ezinesihawu kanye nokwenzeka kwalo kuboniswa ngezinga elikhulu.
Ukwehla okukhulu ushukela wegazi, i-hypoglycemia noma i-edema yamakhorali ingaqala ukukhula. Kubalwe lapha yimicimbi engemihle engahle yenzeke ezigulini. Zihlukaniswa ngezigaba zesitho sohlelo:
- imvamisa ayaziwa (ngokusho kwedatha ekhona, akunakwenzeka ukunquma imvamisa yokuvela kwemiphumela emibi);
- akuvamile kakhulu (<1/10000);
- ezingavamile (≥1 / 10000 kanye <1/1000);
- infrequent (≥1 / 1000 no <1/100);
- imvamisa (≥1 / 100 kanye <1/10);
- imvamisa kakhulu (≥1 / 10).
Kusuka emasosheni omzimba
- Ukubonakaliswa kwe-allergic kohlobo olusheshayo ngqo ku-insulin noma kulabo abathola isidakamizwa - imvamisa ayaziwa.
- I-Bronchospasms - imvamisa ayaziwa.
- Ukuguqulwa kwesikhumba okujwayelekile - imvamisa ayaziwa.
- Kwehliswe umfutho wegazi - imvamisa ayaziwa.
- I-Angioneurotic edema - imvamisa ayaziwa.
- Ukushaqeka kwe-Anaphylactic ukusabela okungejwayelekile.
- Imijovo ye-insulin ingadambisa amasosha omzimba ku-insulin - imvamisa ayaziwa.
Zonke lezi zigameko zingaba yingozi enkulu empilweni yesiguli, ngenxa yalokho, zidinga usizo ngokushesha. Ukuba khona kwalawa ma-antibodies ezimweni ezingavamile zokulungiswa kungadinga ukuguqula umthamo we-insulin.
Engxenyeni yezondlamzimba nemetabolism
Ngokulawulwa okuthuthukile kwe-metabolic (okwakunganele ngaphambili) ngokusebenzisa ukwelashwa kwe-insulin okunamandla kakhudlwana:
- ukudumba kungenzeka - kaningi;
- ukugcinwa kwe-sodium kwenzeka - imvamisa ayaziwa.
Kusuka kwizitho ezibonakalayo
- Ukuphazamiseka okubukwayo kwesikhashana kungenzeka ngenxa yezinguquko zokulawulwa kwe-glycemic - imvamisa ayaziwa. Inkinga ivela ngenxa yokushintshwa kwesikhashana kwamalensi wamehlo nenkomba yawo yokuphinda asebenze.
- Ukwelashwa kakhulu kwe-insulin ngokulawulwa kwe-glycemic okuthuthukisiwe kungabhekwa njengokuwohloka kwesikhashana kwe-retinopathy yesifo sikashukela - imvamisa ayaziwa.
- Ezigulini ezine-retinopathy ekhulayo (ikakhulukazi kulabo abangakutholi ukwelashwa okuyilona nge-laser therapy), iziqephu ze-hypoglycemic ezinzima kakhulu zingadala ukulahleka okuphelele kombono (i-trurent amaurosis) - imvamisa ayaziwa.
Kusuka kwezicubu zesikhumba ezingaphansi kwesikhumba nesikhumba
Nganoma yikuphi ukwelashwa kwe-insulin, kungenzeka ukuthi i-lipodystrophy ithuthuke endaweni yomjovo futhi inciphise ukumuncwa kwe-insulin yendawo - imvamisa ayaziwa. Ukuphendula okunjalo kunganyamalala uma amasayithi womjovo eguqulwa njalo ngaphakathi kwendawo enconyiwe.
Ukuphazamiseka endaweni yokujova kanye nokuphazamiseka okujwayelekile
Ukuphendula okuthambile kuvame ukwenzeka kumasayithi omjovo. Kubandakanya:
- ubuhlungu endaweni yokuphatha - imvamisa ayaziwa;
- ubomvu endaweni yokuphatha - imvamisa ayaziwa;
- i-urticaria endaweni yokuphatha - imvamisa ayaziwa;
- ukulunywa endaweni yezokuphatha - imvamisa ayaziwa;
- ukuvuvukala endaweni yezokuphatha - imvamisa ayaziwa;
- ukuvuvukala endaweni yomjovo - imvamisa ayaziwa.
Ngisho nokusabela okuqinile kakhulu kwi-hormone-insulin endaweni yomjovo kuvame ukunyamalala ngemuva kwezinsuku noma amasonto ambalwa.
Imiyalo yokusebenzisa
Amalungiselelo e-insulin azosetshenziswa; inani lokuhlushwa ushukela wegazi; irejimusi yemithamo ye-insulin (isikhathi somjovo nedosi) kufanele isungulwe futhi ilungiswe ngamunye. Lokhu kuyadingeka ukuthobela:
- indlela yokuphila yesiguli;
- izinga lomsebenzi womzimba;
- ukudla.
Ayikho imithetho esungulwe kahle yomthamo we-insulin. Kodwa-ke, kunomthamo we-insulin ophakathi kuka-0.5-1 IU / kg / s. Kuyisici ukuthi umthamo we-insulin osebenza isikhathi eside usebenza kusuka kuma-40% ukuya kuma-60% womthamo we-insulin odingeka kumuntu ngaso sonke isikhathi.
Udokotela kufanele anikeze isiguli izincomo nemiyalo edingekayo:
- maqondana nanoma yiluphi ushintsho ohlelweni lokwelashwa kwe-insulin;
- maqondana nezinguquko ekudleni;
- ngemvamisa yokuthola ukugcwala koshukela egazini.
Inguquko esuka eBazal
Lapho kudluliswa iziguli zisuka kwenye i-insulin ziyiswe kwenye i-insulin, ukulungiswa kwendlela yemithamo ye-hormone kungadingeka. Kungaba:
- ukushintshwa kwe-insulin yomuntu kusuka ku-insulin yemvelaphi yesilwane;
- ukuguqulwa komuthi owodwa we-insulin yomuntu uye kwesinye;
- noma lapho ushintsha ukwelashwa nge-insulin esebenza nge-insulin engamuntu ungene ohlelweni olubandakanya ukusetshenziswa kwe-insulin esebenza isikhathi eside.
Lapho ushintsha i-insulin yemvelaphi yezilwane iye kwi-insulin yomuntu, kungahle kudingekile ukunciphisa umthamo wayo.
Lokhu kuyiqiniso ikakhulukazi kulezi ziguli:
- phambilini bekubhekwe kakhulu ushukela wegazi;
- ngokubheka ukuba khona kwama-antibodies ku-insulin, imithamo yawo ephezulu yayisetshenziswa ngaphambili;
- ube nesifiso sokuthuthuka kwe-hypoglycemia.
Isidingo sokunciphisa umthamo singavela ngokushesha ngemuva kokushintshela kolunye uhlobo lwe-insulin, futhi singakhula kancane (amasonto ambalwa). Ngesikhathi soshintsho kusuka kwelinye i-insulin kuye kwelinye, kanye nasemavikini ambalwa alandelayo, kulawulwa ngokuqinile ushukela wegazi.
Iziguli, ngenxa yokuba khona kwama-antibodies, zisebenzisa imithamo ephezulu ye-insulin, kufanele zishintshele kolunye uhlobo lwe-insulin kuphela esibhedlela ngaphansi kokuqashwa ngokweqile kwezokwelapha.
Ukuguqulwa komthamo
Ukuzwela kwe-insulin okwandayo kungahle kube khona ngenxa yokulawulwa okuthuthukile kwe-metabolic. Ngenxa yalokho, isidingo somzimba se-insulin singancipha.
Ukuguqulwa komthamo kungenzeka kudingekile ngaphansi kwezinye izimo:
- ushintsho kwesisindo somzimba wesiguli;
- Izinguquko zokuphila, kufaka phakathi izinga lokuzivocavoca umzimba nokudla;
- izimo ezifaka isandla ekuthuthukiseni i-hyper- kanye ne-hypoglycemia.
Imilinganiselo yesilinganiso samaqembu akhethekile eziguli
- Abantu asebekhulile - kuleli qembu, ngokuhamba kwesikhathi, isidingo se-insulin singancipha. Ngakho-ke, qala ukwelashwa kwe-insulin, khetha imithamo yesondlo noma ukwandise umthamo weziguli esezikhulile ezinesifo sikashukela kufanele kube ngokuqapha ngokweqile. Ngaphandle kwalokho, ukusabela kwe-hypoglycemic kungacasulwa.
- Iziguli ezinokulimazeka kwe-renal noma hepatic. Lababantu, futhi, bangadinga i-insulin encane.
Umjovo wezidakamizwa
I-Basal ivame ukuphathwa ngokujulile, imizuzu engama-45-60 ngaphambi kokudla. Isikhathi ngasinye kunconywa ukushintsha indawo yomjovo ngaphakathi kwendawo efanayo. Isibonelo, isisu sishintsha endaweni ye-hip. Kepha lolu shintsho lungenzeka kuphela ngemuva kokubonisana nodokotela kwangaphambilini.
Lokhu kuyadingeka ngoba i-insulin adsorption, futhi ngenxa yalokho umphumela wokwehla kwamazinga kashukela wegazi, angaguquguquka kuye ngokuthi injolini le-insulin (ngokwesibonelo, ithanga noma isisu).
IBazal ayisetshenziswa ezinhlotsheni ezahlukahlukene zamaphampu we-insulin (kufaka namaphampu okufakwa). Ukuphathwa okumaphakathi kwesidakamizwa akwamukeleki ngokuphelele! Akunakwenzeka ukuvumela ukuxubaniswa kweBazal nge-insulin analogues, i-insulin yemvelaphi yezilwane, i-insulin yokuhlushwa okuhlukile nezinye izidakamizwa.
I-Bazal ingaxutshwa nanoma yikuphi amalungiselelo e-insulin omuntu akhiqizwa yiSanofi-aventis Group. Kepha nge-insulin, eyenzelwe ngokukhethekile amaphampu e-insulin, iBazal akufanele ihlanganiswe.
Kufanele ukhumbule njalo ukuthi inani le-insulin lisesilinganisweni se-100 IU / ml (kuma-cartridge we-3 ml noma ama-5 ml. Yingakho udinga ukusebenzisa kuphela amapeni wejinji we-KlikSTAR noma ama-OptiPen Pro1 (uma kusetshenziswa ama-cartridge), noma amasirinji epulasitiki enzelwe wona lokhu kuhlushwa.
Kumjova weplastiki awukwazi ukuba esinye isidakamizwa noma izinsalela zawo. Lapho uqoqa i-insulin kusuka ku-vial okokuqala, kufanele ususe cap yepulasitiki ekugcineni. Ukuba khona kwayo kukhombisa ukuthi ibhodlela belingakavulwa ngaphambili.
Izimpawu zokweqisa komuthi
Ukwethulwa kwe-insulin ethe xaxa, okungukuthi, okweqisa kwayo uma kuqhathaniswa nezindleko zamandla noma ukudla okudliwayo, kungaholela ekutheni kube ne-hypoglycemia ende, esongela impilo.
Ukwelashwa
Uma isiguli sazi, lokhu kubonisa isiqephu esithambile se-hypoglycemia. Lezi ziqephu ezinjalo zimiswa ngokufakwa ama-carbohydrate. Kodwa ukulungiswa komthamo we-insulin, ukusebenza ngokomzimba kanye nokudla ukudla kusadingeka.
Iziqephu ezingathi sína ze-hypoglycemia, lapho isiguli siwela ku-coma, ukuphazamiseka kwemizwa noma ukuvela, kungaqedwa ngokuphathwa kwe-glucagon noma kwe-subcutaneous kwesisombululo se-dextrose esihlanganisiwe.
Inani le-dextrose elilawulwa ezinganeni lisetwa ngokulingana nesisindo somzimba wengane. Ngemuva kokukhuphuka kokushukela egazini kuphakama, kungahle kube nesidingo sokudla kakhulu ama-carbohydrate. Ingane kufanele igadwe, ukuze kuthi ngemuva kokuthuthuka okubonakalayo kokugula, ukuvela kabusha kwe-hypoglycemia kungenzeka.
Endabeni ye-hypoglycemia ende noma enzima ngemuva kokuphathwa kwe-glucagon noma i-dextrose, kubalulekile ukufaka isisombululo se-dextrose esingagcwele. Lokhu kuyadingeka ukuze kuvinjelwe ukwenziwa kabusha kwe-hypoglycemia.
Kuyadingeka ukuqapha ngokucophelela ukugcwala kwe-glucose egazini ezinganeni ezincane, lokhu kuzosiza ukuvimbela ukuthuthukiswa kwe-hyperglycemia enzima.
