Iningi leziguli ezinesifo sikashukela i-mellitus libekezelela ukwelashwa kwe-insulin uma kusetshenziswa imithamo ekhethwe kahle. Kepha kwezinye izimo, ukusabela okwenziwa yi-insulin noma izingxenye ezengeziwe zesidakamizwa, kanye nezinye izici, kungabonakala.
Ukuboniswa kwasendaweni ne-hypersensitivity, ukungabekezeleli
Ukubonakaliswa kwasendaweni endaweni yomjovo we-insulin. Lokhu kusabela kufaka phakathi izinhlungu, ubomvu, ukuvuvukala, ukulunywa, i-urticaria nezinqubo zokuvuvukala.
Eziningi zalezi zimpawu zimnene futhi zivame ukuvela ezinsukwini noma amasonto ambalwa ngemuva kokuqala ukwelashwa. Kwezinye izimo, kungahle kudingekile ukufaka esikhundleni se-insulin ngomuthi oqukethe ezinye izilondolozi noma abaqinisi.
I-hypersensitivity esheshayo - ukusabela okunjalo komzimba kungathuthuki kakhulu. Zingakha zombili ku-insulin uqobo nasemakhompiyutheni asizayo, futhi zibonakalise ukusabela okujwayelekile kwesikhumba:
- bronchospasm,
- i-angioedema
- kwehle umfutho wegazi, ukwethuka.
Okusho ukuthi, konke lokhu kungaba yingozi empilweni yesiguli. Ngama-allergies ajwayelekile, kuyadingeka ukubuyisela umuthi esikhundleni se-insulin esisebenza okwesikhashana, futhi kubalulekile ukwenza izindlela zokulwa nokungezwani komzimba.
Ukubekezelelwa kwe-insulin okumpofu ngenxa yokuwa kwesilinganiso esijwayelekile sesikhathi eside se-glycemia ende. Uma izimpawu ezinjalo zenzeka, lapho-ke kufanele ulondoloze izinga le-glucose ezingeni eliphakeme cishe izinsuku eziyi-10, ukuze umzimba ukwazi ukuzivumelanisa nenani elijwayelekile.
Ukulimazeka kokubonakalayo kanye ne-sodium excretion
Imiphumela emibi evela ohlangothini lokubuka. Ushintsho olunamandla ekugxilisweni kweglucose yegazi ngenxa yomthetho kungaholela ekuphazamisweni okwesikhashana kokubonakalayo, njengoba ukuguqulwa kwezicubu kwethisithisi kanye ne-lens refraction value kunciphisa ukunciphiswa kwamehlo (ukwanda kwe-lens hydration).
Ukusabela okunjalo kungabonakala ekuqaleni kokusetshenziswa kwe-insulin. Lesi simo asidingi ukwelashwa, udinga kuphela:
- ukunciphisa uhlobo lwamehlo
- Sebenzisa ikhompyutha encane
- funda okuncane
- bukela i-TV encane.
UbuhlunguAbantu kufanele bazi ukuthi lokhu akubeki ingozi futhi kumbono wamasonto ambalwa uzobuyiselwa.
Ukwakhiwa kwamasosha omzimba ekwethulweni kwe-insulin. Kwesinye isikhathi ngokusabela okunjalo, ukulungiswa kwamthamo kuyadingeka ukuqeda amathuba okukhula kwe-hyper- noma hypoglycemia.
Ezimweni ezingavamile, i-insulin ibambezela ukuphuma kwe-sodium, okuholela ekuvuvukeni. Lokhu kuyiqiniso ikakhulukazi ezimweni lapho ukwelashwa kwe-insulin okunamandla kubangela ukuthuthukiswa okubukhali kwe-metabolism. I-insulin edema yenzeka ekuqaleni kwenqubo yokwelashwa, ayinabungozi futhi imvamisa inyamalala ngemuva kwezinsuku ezintathu kuya kwezine, yize kwezinye izimo ingahlala kuze kuphele amasonto amabili. Ngakho-ke, kubaluleke kakhulu ukwazi ukuthi ungawujova kanjani i-insulin.
I-Lipodystrophy nokusabela kwezidakamizwa
I-Lipodystrophy. Ingabonakala njenge-lipoatrophy (ukulahleka kwezicubu ezi-subcutaneous) ne-lipohypertrophy (ukwakhiwa kwezicubu ezandisiwe).
Uma umjovo we-insulin ungena endaweni ye-lipodystrophy, khona-ke ukumunca i-insulin kungahle kwehle, okuzoholela ekushintsheni kwe-pharmacokinetics.
Ukunciphisa ukubonakaliswa kwalokhu kusabela noma ukuvimba ukuvela kwe-lipodystrophy, kunconyelwa ukuthi kuguquke njalo indawo yokujova ngaphakathi kwemingcele yendawo eyodwa yomzimba okuhloswe ngayo ukuphathwa kwe-insulin ngokungaziphathi.
Ezinye izidakamizwa zenza buthaka umphumela wehlisela ushukela. Le mishanguzo ifaka:
- glucocorticosteroids;
- okokugcobisa;
- danazole;
- diazoxide;
- isoniazid;
- i-glucagon;
- ama-estrogens nama-gestagens;
- ukukhula kwehomoni;
- okususelwa ku-phenothiazine;
- ama-hormone egilo;
- i-sympathomimetics (i-salbutamol, i-adrenaline).
I-Alcohol ne-clonidine kungaholela kwimiphumela eyandisiwe nebuthakathaka ye-hypoglycemic ye-insulin. I-Pentamidine ingaholela ku-hypoglycemia, yona-ke ethathelwa indawo yi-hyperglycemia, njengesenzo esilandelayo.
Eminye imiphumela nemiphumela emibi
I-Somoji syndrome yi-posthypoglycemic hyperglycemia eyenzeka ngenxa yomthelela wokunxephezelana wamahomoni we-contra-hormone (glucagon, cortisol, STH, catecholamines) njengokuphendula kokushoda kwe-glucose kumaseli wobuchopho. Ucwaningo lukhombisa ukuthi e-30% yeziguli ezinesifo sikashukela kune-hypoglycemia engatholakali, lokhu akuyona inkinga nge-hypoglycemic coma, kodwa akufanele kunganakwa.
Ama-hormone angenhla athuthukisa i-glycogenolysis, omunye umphumela omubi. Ngakho-ke ukusekela ukugxilwa okudingekayo kwe-insulin egazini. Kepha la mahomoni, njengomthetho, afihlwe ngobukhulu obukhulu kunesidingo, okusho ukuthi i-glycemia yokuphendula nayo ingaphezu kwezindleko. Lesi simo singathatha amahora amaningi kuya ezinsukwini eziningana futhi sibizwa kakhulu ekuseni.
Inani eliphakeme le-hyperglycemia yasekuseni lihlala liphakamisa lo mbuzo: okweqile noma ukushoda kwe-insulin isikhathi eside? Impendulo efanele izokuqinisekisa ukuthi i-carbohydrate metabolism izonxephezelwa kahle, ngoba esimweni esisodwa umthamo we-insulin ebusuku kufanele uncishiswe, futhi kwesinye kufanele wenyuswe noma usatshalaliswe ngokuhlukile.
I "Morning Dawn Phenomenon" yisimo se-hyperglycemia ekuseni (kusuka emahoreni ama-4 kuye kwayi-9) ngenxa yokwanda kwe-glycogenolysis, lapho i-glycogen esibindini igqabhuka khona ngenxa yokuqothuka ngokweqile kwama-hormone we-contrainsulin ngaphandle kwe-hypoglycemia yangaphambilini.
Ngenxa yalokhu, ukumelana ne-insulin kwenzeka kanye nesidingo sokunyuka kwe-insulin, kungaphawulwa lapha ukuthi:
- Isidingo esiyisisekelo sisezingeni elifanayo ukusuka ku-10 p.m. kuya phakathi kwamabili.
- Ukuncishiswa kwaso ngo-50% kwenzeka kusuka ngo-12 a.m kuya ku-4 a.m.
- Ukukhuphuka kwenani elifanayo kusuka ku-4 kuye ku-9 ekuseni.
Kunzima kakhulu ukunikeza i-glycemia esitebeleni ebusuku, ngoba namalungiselelo e-insulin anwetshiwe wesimanje awakwazi ukulingisa ngokuphelele ushintsho olunjalo lomzimba ekusetshenzisweni kwe-insulin.
Esikhathini sokudalwa ngokomzimba okunciphile okwehla kwesidingo sobusuku be-insulin, umphumela oyingozi ubungozi be-hypoglycemia yangemuva kokungenisa umuthi oweluliwe ngaphambi kokulala ngenxa yokwanda komsebenzi we-insulin ende. Ukulungiselela okusha okuhlala isikhathi eside (okungenantambo), ngokwesibonelo, i-glargine, kungasiza ukuxazulula le nkinga.
Kuze kube manje, akukho ukwelashwa oku-etiotropic kohlobo lwe-1 yesifo sikashukela, yize imizamo yokuyithuthukisa iyaqhubeka.
